Long-term physical activity, later biological aging, and all-cause mortality: A study in review
- Christopher Zambakari
- Oct 1
- 5 min read
Dr. Christopher Zambakari, B.S., MBA, M.I.S., LP.D.
Owner/Operator; Desert Haven Home Care, Apollo Residential Assisted Living, Villa Fiore Assisted Living-Prescott Valley
Under a single home care umbrella, Desert Haven Home Care, Apollo Residential Assisted Living, and Villa Fiore Assisted Living-Prescott feature unparalleled care, feature unparalleled care, service and advocacy in the compassionate treatment of senior citizens in need of medical attention. Offered in a familial setting, the facilities are teamed by professionals passionate about their work and fully engaged in the welfare of residents. Each facility proudly provides patient-centric supervisory, assisted and directed care, short-term respite stays and memory care support for Alzheimer’s and dementia patients.
Less may be more. Or, more isn’t necessarily better. So finds a new study published in the European Journal of Epidemiology.
With a cumbersome, take-two-breaths title, “The associations of long-term physical activity in adulthood with later biological ageing and all-cause mortality—a prospective twin study,” the investigation was conducted over a 30-year period and produced some surprises. The results challenge long-held beliefs about the benefits of physical activity, while offering nuanced insights into how our exercise habits can influence our lifespan. The bottom line is this: The relationship between leisure-time physical activity (LTPA) and a lower risk of mortality is susceptible to influences from other sources.
It’s not simply physical activity that will slow your journey to life’s finish line, but rather a combination of LTPA and lifestyle choices.
The study, whose findings were shared by the Journal in January of this year, followed a large cohort of adult twins from Finland, tracking their LTPA patterns over 15 years and monitoring mortality for 30 years. By limiting the sample to biological twins, the researchers were able to control for genetic and shared environmental factors, providing a unique perspective on the true impact of physical activity on longevity.
Physical activity + lifestyle = longer life
It shouldn’t cause pause to note that exercise and informed lifestyle habits are beneficial to healthy outcomes. In fact, a finding of the study showed that the beneficial associations of long-term LTPA with slower biological aging and reduced mortality were largely accounted for by other health-related factors. Noted the study’s authors, “The association between LTPA and lower all-cause mortality [death due to any cause] may be largely due to a healthy phenotype and an overall healthy lifestyle (italics my own for emphasis) co-occuring with high levels of LTPA and a lower mortality risk. When considering biological aging and all-cause mortality, following an overall healthy lifestyle may be more beneficial than maintaining high levels of LTPA (italics my own for emphasis).”
In other words, while being physically active is associated with living longer, much of this benefit may be due to other lifestyle choices that often accompany regular exercise, rather than the exercise itself. You might say, appropriately, it takes a village of factors to position yourself for a longer life.
While being physically active is associated with living longer, much of this benefit may be due to other lifestyle choices that often accompany regular exercise, rather than the exercise itself. You might say, appropriately, it takes a village of factors to position yourself for a longer life.
The researchers identified four distinct classes of long-term LTPA patterns: sedentary, moderately active, active, and highly active. Interestingly, the most significant reduction in all-cause mortality—about 7%—was observed, on average, when participants achieved the recommended minimum amount of LTPA. Different from the idea that more is better, in this case, higher levels of activity did not provide additional benefits in terms of mortality risk. Echoing the study’s findings, the Cleveland Clinic notes that over-exercise “can weaken your immune system and may cause osteoporosis and bone loss in women. In extreme cases, heart damage and rhythm disorders can occur.”
The most significant reduction in all-cause mortality—about 7%—was observed, on average, when participants achieved the recommended minimum amount of LTPA. Different from the idea that more is better, in this case, higher levels of activity did not provide additional benefits in terms of mortality risk.
Biological aging and ‘reverse causality’
Another crucial aspect of the study was its examination of biological aging. The researchers used advanced epigenetic clocks—because “biological” age may differ from “chronological” age, an epigenetic clock is a biomedical test that can be used to measure age—to provide a more accurate picture of how our bodies are aging at a cellular level. While there were differences in biological aging among the four distinct LTPA classes listed above, these variations were largely explained by other health-related factors.
The study also addressed the issue of reverse causality—the possibility that poor health leads to less physical activity, rather than less activity leading to poor health. By examining short-term and long-term mortality—the probability that one will die within a time span; long- or short-term—separately, the researchers found that the association between long-term LTPA and all-cause mortality was more consistent in the short term. This suggests that some of the observed benefits of physical activity may indeed be due to reverse causality.
Among the findings
One of the strengths of the study was the researchers’ use of twin pairs to control for genetic and shared environmental factors. When comparing twins with different activity levels, the differences in mortality risk were considerably lessened after accounting for other lifestyle-related factors and excluding pairs where one or both twins reported cardiovascular diseases. This finding suggests that genetic and early environmental factors play a significant role in the relationship between physical activity and longevity (italics my own for emphasis).
It’s important to note that while the study found smaller differences in mortality between activity levels than previous research, this may be due to the longer follow-up period. The researchers observed that longer follow-up times are associated with weaker associations between physical activity and mortality.
The research also highlights the complexity of studying the relationship between physical activity and health outcomes. Factors such as reverse causality, genetic predisposition, and other lifestyle choices all play important roles that can be difficult to disentangle. By limiting the sample to biological twins, some of this disentanglement was alleviated for a more meaningful conclusion.
Conclusion
So, how does such a study resonate with the average adult person? While the research doesn’t negate the importance of physical activity—what research would?—it does suggest that we need to think about health more holistically. Achieving the recommended minimum amount of physical activity is beneficial, but it’s equally important to consider other lifestyle factors such as diet, smoking, alcohol consumption, and overall health status. And don’t forget genetics.
Because our own unique biological age and physical and emotional environments dictate our physical activity levels, our lifestyle choices play an equally important part of the longevity picture. As always, consult with your healthcare team when considering significant changes to your exercise routines, dietary choices, and other factors that can impact your health—for better or for worse.
About the Author
Dr. Christopher Zambakari is the owner and operator of three Arizona-based assisted living care homes – Desert Haven Home Care in Phoenix, Apollo Residential Assisted Living in Glendale, and Villa Fiore Assisted Living in Prescott Valley, Arizona. He provides direction and oversight to a team of licensed medical and caregiving professionals to ensure the highest levels of customized care, service and advocacy at each of his facilities. Zambakari is founder and CEO of The Zambakari Advisory, an international consultancy in the areas of strategic intelligence, program design and transitional processes. He is a Hartley B. and Ruth B. Barker Endowed Rotary Peace Fellow, and the assistant editor of the Bulletin of The Sudans Studies Association.
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