Is physical activity a cause of longevity? It is not as straightforward as some would believe. A critical analysis
Open accessAbstract
There are discrepant findings between (A) observational follow-ups and (B) interventional studies that investigate possible causal association between high physical activity and low mortality. Participation in vigorous physical activity at a specific time-point is an indicator of good fitness and health, and is associated with a reduced risk of death. However, neither randomised controlled trials nor experimental animal studies have provided conclusive evidence to show that physical activity started during adulthood extends lifespan. Consequently, the undisputed health-related benefits of exercise have yet to translate into any proven causal relationship with longevity. Physical activity improves fitness and physical function, and confers other health-related effects. These outcomes have a greater basis in evidence-based data than any claims of a reduced risk of death, especially when recommending physical activity for previously physically inactive middle-aged and elderly adults.
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The rapidly aging population and higher death rates among older adults make this population particularly interesting for testing whether a causal relation exists between the current advice on physical activity levels and longevity.
“The rapidly aging population and higher death rates among older adults make this population particularly interesting for testing whether a causal relation exists between the current advice on physical activity levels and longevity.2”
From Effect of exercise training for five years on all cause mortality in older adults—the Generation 100 study: randomised controlled trial (2020) · cites this paper as [2]
The 'Evidence from Randomised Controlled Trials' section (page unavailable) says that studying elderly people at increased risk of death might make an exercise effect on mortality easier to detect. 'Challenges to Moving Forward' adds that deaths are rare in younger groups and describes an older-adult exercise trial. The copy does not identify a rapidly aging population as a reason for this research or specifically frame the question around current physical-activity advice. (LLM, conf=0.85)
Experimental — accuracy not yet measuredSceptics of the benefits from physical activity have argued that the guideline recommendations lack the high quality evidence provided by randomised clinical trials.
“Sceptics of the benefits from physical activity have argued that the guideline recommendations lack the high quality evidence provided by randomised clinical trials.2”
From Effect of exercise training for five years on all cause mortality in older adults—the Generation 100 study: randomised controlled trial (2020) · cites this paper as [2]
The “Evidence from Randomised Controlled Trials” section says trials have not conclusively shown that exercise extends lifespan or reduces premature death. The claim broadens that limitation to guideline recommendations about physical activity benefits generally; the paper also says exercise has established fitness, function and other health benefits. Page numbers are unavailable in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredExercise and physical activity enhance physical function and quality of life and diminish the burden of non-communicable diseases and premature mortality, including deaths from cardiovascular disease, cancer, and chronic lower respiratory tract diseases.
“Exercise and PA not only enhance physical function and quality of life but also diminish the burden of non-communicable diseases and premature mortality, including deaths from CVD, cancer, and chronic lower respiratory tract diseases [[74], [75], [76], [77]]”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [74]
Exercise and PA enhance physical function and quality of life and diminish the burden of non-communicable diseases and premature mortality, including deaths from CVD, cancer, and chronic lower respiratory tract diseases.
“Exercise and PA not only enhance physical function and quality of life but also diminish the burden of non-communicable diseases and premature mortality, including deaths from CVD, cancer, and chronic lower respiratory tract diseases [[74], [75], [76], [77]].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [74]
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Polygenic Score for Physical Activity Is Associated with Multiple Common Diseases
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Leisure-Time Physical Activity and Cancer Risk Among Older Adults: A Cohort Study
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Chance and Causality in Ageing and Longevity
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Exercise as a Therapy for Successful Aging
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- Authors
- Kujala, U. M.
- Affiliations
- University of Jyväskylä (FI)
- Corresponding author
- Kujala, Urho M
- ORCID
- Kujala, Urho M
- Venue
- British Journal of Sports Medicine
- Publisher
- BMJ
- Published
- 2018-03-15
- Volume
- 52
- Issue
- 14
- Pages
- 914-918
- ISSN
- 0306-3674 (ISSN-L)
- 1473-0480
- OpenAlex
- W2791946884
- Cited by
- 83
- References
- 68
- Citations by year
- 2026: 3 · 2025: 12 · 2024: 15 · 2023: 3 · 2022: 11 · 2021: 12 · 2020: 11 · 2019: 10 · 2018: 6
- FWCI
- 1.28
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- British Journal of Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- Jyväskylä University Digital Archive (University of Jyväskylä) (submittedVersion, cc-by-nc)
- HighWire Press Open Archive (submittedVersion)
- Funders
- The Finnish Ministry of Education and Culture
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
- Keywords
- physical activity, longevity, mortality, lifespan extension, causal inference, physical fitness, physical function, health benefits of exercise, physical inactivity, middle-aged and older adults
- MeSH terms
- Animals, Health Status, Humans, Longevity, Physical Fitness, Exercise, Randomized Controlled Trials as Topic, Observational Studies as Topic
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