Numerous studies consistently have shown that higher levels of physical activity are associated with decreased risks of coronary heart disease, cerebrovascular disease, hypertension, non-insulin-dependent diabetes mellitus, colon and, possibly, breast cancer, as well as osteoporosis. The biological processes proposed to explain these inverse associations are highly plausible. If physical activity does reduce the risk of developing these chronic diseases, we also would expect physical activity to delay mortality and enhance longevity. In this article, we review the major epidemiological studies worldwide that have examined the association between physical activity or physical fitness and all-cause mortality. The data from these studies indicate that physical activity is effective in postponing mortality and enhancing longevity. Public health professionals worldwide should emphasize the need to increase activity levels during leisure time, as well as the need to incorporate physical activity into the daily activities of life.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
Lyons A.S., Petrucelli R.J.: Medicine: An illustrated history. Abradale Press, Harry N. Abrams Inc., New York, 1978.
Smith E.: Report on the sanitary conditions of tailors in London. Report of the Medical Officer. The Privy Council, London, 1864, pp. 416–430.
Sivertsen I., Dahlstrom A.W.: The relation of muscular activity to carcinoma: A preliminary report. J. Cancer Res. 6: 365–378, 1922.
Hartley P.H.S., Llewellyn G.F.: The longevity of oarsmen: A study of those who rowed in the Oxford and Cambridge boat race from 1829-1928. Br. Med. J. 1: 657–662, 1939.
Rook A.: An investigation into the longevity of Cambridge sportsmen. Br. Med. J. 1: 773–777, 1954.
Pomeroy W.C., White P.D.: Coronary heart disease in former football players. JAMA 167: 711–714, 1958.
Bouchard C., Shephard R.J., Stephens T., (Eds.): Physical activity, fitness, and health: International proceedings and consensus statement. Human Kinetics Publishers, Champaign, IL, 1994.
US Department of Health and Human Services: Physical activity and health: A report of the Surgeon General. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA, 1996.
Morris J.N., Heady J.A., Raffle P.A.B., Roberts C.G., Parks J.W.: Coronary heart-disease and physical activity of work. I. Coronary heart-disease in different occupations. Lancet 2: 1053–1057, 1953.
Morris J.N., Crawford M.D.: Coronary heart disease and physical activity of work: Evidence of a national necropsy survey. Br. Med. J. 2: 1485–1496, 1958.
Morris J.N., Everitt M.G., Pollard R., Chave S.P.W., Sem-mence A.M.: Vigorous exercise in leisure-time: Protection against coronary heart disease. Lancet 2: 1207–1210, 1980.
Morris J.N., Clayton D.G., Everitt M.G., Semmence A.M., Burgess E.H.: Exercise in leisure-time: Coronary attack and death rates. Br. Heart J. 63: 325–334, 1990.
Chave S.P.W., Morris J.N., Moss S., Semmence A.M.: Vigorous exercise in leisure time and the death rate: A study of male civil servants. J. Epidemiol. Community Health 32: 239–243, 1978.
Paffenbarger R.S. Jr., Wolf P.A., Notkin J., Thorne M.C.: Chronic disease in former college students. I. Early precursors of fatal coronary heart disease. Am. J. Epidemiol. 83: 314–328, 1966.
Paffenbarger R.S. Jr., Laughlin M.E., Gima A.S., Black R.A.: Work activity of longshoremen as related to death from coronary heart disease and stroke. N. Engl. J. Med. 282: 1109–1114, 1970.
Paffenbarger R.S. Jr., Hale W.E.: Work activity and coronary heart mortality. N. Engl. J. Med. 292: 545–550, 1975.
Paffenbarger R.S. Jr., Wing A.L., Hyde R.T.: Physical activity as an index of heart attack risk in college alumni. Am. J. Epidemiol. 108:161–175, 1978.
Paffenbarger R.S. Jr., Hyde R.T., Wing A.L., Steinmetz C.H.: A natural history of athleticism and cardiovascular health. JAMA 252: 491–495, 1984.
Paffenbarger R.S. Jr., Hyde R.T, Wing A.L., Hsieh C-c.: Physical activity and longevity of college alumni. N. Engl. J. Med. 315: 399–401, 1986.
Paffenbarger R.S. Jr., Hyde R.T., Wing A.L., Lee I-M., Jung D.L., Kampert J.B.: The association of changes in physical activity level and other lifestyle characteristics with mortality among men. N. Engl. J. Med. 328: 538–545, 1993.
Lee I-M., Hsieh C-c., Paffenbarger R.S. Jr.: Exercise intensity and longevity in men: The Harvard Alumni Health Study. JAMA 273: 1179–1184, 1995.
Slattery M.L., Jacobs D.R. Jr., Nichaman M.Z.: Leisure time physical activity and coronary heart disease death: The US Railroad Study. Circulation 79: 304–311, 1989.
Pekkanen J., Marti B., Nissinen A., Tuomilehto J., Punsar S., Karvonen M.: Reduction of premature mortality by high physical activity: A 20-year follow-up of middle-aged Finnish men. Lancet 1: 1473–1477, 1987.
Salonen J.T., Puska P., Tuomilehto J.: Physical activity and risk of myocardial infarction, cerebral stroke and death: A longitudinal study in Eastern Finland. Am. J. Epidemiol. 115: 526–537, 1982.
Leon A.S., Connett J., Jacobs D.R. Jr., Rauramaa R.: Leisure-time physical activity levels and risk of coronary heart disease and death: The Multiple Risk Factor Intervention Trial. JAMA 258: 2388–2395, 1987.
Lindsted K.D., Tonstad S., Kuzma J.W.: Self-report of physical activity and patterns of mortality in Seventh-Day Adventist men. J. Clin. Epidemiol. 44: 355–364, 1991.
Kaplan G.A., Seeman T.E., Cohen R.D., Knudsen L.P., Guralnik J.: Mortality among the elderly in the Alameda County Study: Behavioral and Demographic Risk Factors. Am. J. Public Health 77: 307–312, 1987.
Simonsick E.M., Lafferty M.E., Phillips C.L., Mendes de Leon C.F., Kasl S.V., Seeman T.E., Fillenbaum G., Hebert P., Lemke J.H.: Risk due to inactivity in physically capable older adults. Am. J. Public Health 83: 1443–1450, 1993.
Blair S.N., Kohl H.W. III, Paffenbarger R.S. Jr., Clark D.G., Cooper K.H., Gibbons L.W.: Physical fitness and all-cause mortality: A prospective study of healthy men and women. JAMA 262: 2395–2401, 1989.
Blair S.N., Kohl H.W. III, Barlow C.E., Paffenbarger R.S. Jr., Gibbons L.W., Macera C.E.: Changes in physical fitness and all-cause mortality: A prospective study of healthy and unhealthy men. JAMA 273: 1093–1098, 1995.
Slattery M.L., Jacobs D.R. Jr.: Physical fitness and cardiovascular disease mortality: The US Railroad Study. Am. J. Epidemiol. 127:571–580, 1988.
Ekelund L-G., Haskell W.L., Johnson J.L., Whaley F.S., Criqui M.H., Sheps D.S.: Physical fitness as a predictor of cardiovascular mortality in asymptomatic North American men: The Lipid Research Clinics Mortality Follow-up Study. N. Engl. J. Med. 319: 1379–1384, 1988.
Sandvik L., Erikssen J., Thaulow E., Erikssen G., Mundal R., Rodahl K.: Physical fitness as a predictor of mortality among healthy, middle-aged Norwegian men. N. Engl. J. Med. 328: 533–537, 1993.
Kramsch D.M., Aspen A.J., Abramowitz B.M., Kreimendahl T., Hood W.B. Jr.: Reduction of coronary atherosclerosis by moderate conditioning exercise in monkeys on an athero-genic diet. N. Engl. J. Med. 305: 1483–1489, 1981.
Blomqvist C.G., Saltin B.: Cardiovascular adaptations to physical training. Annu. Rev. Physiol. 45: 169–189, 1983.
Noakes T.D., Higginson L., Opie L.H.: Physical training increases ventricular fibrillation thresholds of isolated rat hearts during normoxia, hypoxia, and regional ischemia. Circulation 67: 24–30, 1983.
Richardson P.D., Davies M.J., Born G.V.R.: Influence of plaque configuration and stress distribution on fissuring of coronary atherosclerotic plaques. Lancet 2: 941–944, 1989.
Fuster V., Badimon L., Badimon J.J., Chesebro J.H.: The pathogenesis of coronary artery disease and the acute coronary syndromes. N. Engl. J. Med. 326: 242–250, 310-318, 1992.
Kestin A.S., Ellis P.A., Barnard M.R., Errichetti A., Rosner B.A., Michelson A.D.: Effect of strenuous exercise on platelet activation state and reactivity. Circulation 88: 1502–1511, 1993.
Schulman S.P., Fleg J.L., Goldberg A.P., Busby-Whitehead J., Hagberg J.M., O’Connor F.C., Gerstenblith G., Becker L.C., Katzel L.I., Lakatta L.E., Lakatta E.G.: Continuum of cardiovascular performance across a broad range of fitness levels in healthy older men. Circulation 94: 359–367, 1996.
Pate R.R., Pratt M., Blair S.N., Haskell W.L., Macera C.A., Bouchard C., Buchner D., Ettinger W., Heath G.W., King A.C., Kriska A., Leon A.S., Marcus B.H., Morris J., Paffenbarger R.S.Jr, Patrick K., Pollock M.L., Rippe J.M., Sallis J., Wilmore J.H.: Physical activity and public health: A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 273: 402–407, 1995.
About this article
Cite this article
Lee, I.M., Paffenbarger, R.S. & Hennekens, C.H. Physical activity, physical fitness and longevity. Aging Clin Exp Res 9, 2–11 (1997). https://doi.org/10.1007/BF03340123
- physical activity
- physical fitness