How Fitness in Your 50s May Predict Your Lifespan
Middle-aged athletes – men and women – are used to facing criticism or skepticism from our sedentary peers. It’s a midlife crisis, vanity, an attempt to recapture our youth, a way of denying that we’re getting older, and the list goes on. What they fail to understand is that we don’t train to hold on to the past, but rather to live our best lives now and to prepare to lead healthy and active lives for decades to come. And research shows that the training you do in your 40s and 50s can add years to your life and life to your years.
Data from the Copenhagen Male Study
The study by Johan Clausen and his team and published in the Journal of the American College of Cardiology used initial data from 1970-71 on 5,107 healthy, employed men in the Copenhagen Male Study and 45 years worth of follow-up data. Their goal was to find out whether cardiorespiratory fitness (CRF) in middle age (the average age was 48.8 years old when initial data was gathered) affected all-cause mortality and mortality due to cardiovascular disease. The men were categorized into one of four groups, based on maximum aerobic capacity:
- Below the lower limit of normal: average VO2 max of 20.7 ml/kg/min
- Low normal: average VO2 max of 28.3 ml/kg/min
- High normal: average VO2 max of 37.1 ml/kg/min
- Above the upper limit of normal: average VO2 max of 49.6 ml/kg/min
Forty-five years after the initial data was collected, 92% of the men had died. Of the 4700 deaths, 42% were caused by cardiovascular disease. However, throughout all the ways the data was analyzed, higher CRF in middle age was associated with greater longevity. The table below summarizes the number of additional years the Low Normal, High Normal, and Above Upper Limit of Normal groups lived, compared to the Below Lower Limit of Normal group.
Table: Additional Years of Life
|Analysis type||Cause of Death||Low Normal CRF||High Normal CRF||Above Upper Limit of Normal CRF|
|Age only||All-Cause mortality||+3 years||+4.2 years||+6.4 years|
|Multivariable||All-Cause mortality||+2.1 years||+2.9 years||+4.9 years|
|Age only||Cardiovascular mortality||+3.3 years||+4.4 years||+6.7 years|
|Multivariable||Cardiovascular mortality||+2.2 years||+2.6 years||+4.5 years|
The Above Upper Limit of Normal (AULN) group is most relevant to the audience for this blog, because the VO2 max values are similar to what we see in moderately- to well-trained men in their 40s and 50s. Men with AULN CRF at age 48 lived +6.4-6.7 years longer than men with Below Lower Limit of Normal (BLLN) CRF. Then they accounted for other variables: adjustment for age at inclusion, body mass index, self-reported physical activity (light, moderate, or high), baseline diabetes (yes/no), smoking status (present, prior, or never), alcohol consumption (0 to 2 U/day, 3 to 5 U/day, or >5 U/day), systolic blood pressure >140 mm Hg, and socioeconomic status (high, middle, or low). With those variables considered, longevity for the AULN group decreased a bit, but was still +4.5-4.9 years.
This study’s findings are in line with other established research that has consistently shown an inverse association between CRF and mortality (higher CRF, lower risk of an early death). Exercise is good for you. No big surprise there. But there’s more to it than that.
Applies to women, too!
This study, like very many in health and exercise science, was all-male. This is an issue our friend Dr. Stacy Sims has spoken about frequently, including this Outside Magazine article. Although the study itself used data from an all-male cohort, it is hard to believe that higher CRF in middle age doesn’t also increase longevity for women. Perhaps the values used to create VO2 max categories would be different if the study included men and women, or just women, but it’s likely the trend lines would be very similar.
You have to show up.
To elevate and maintain a higher aerobic capacity and an ability to do more work, you have to be consistently active. When you stress energy systems 3 or more times per week, every week, they don’t have time to decline. Hard workouts done infrequently and haphazardly are better than nothing, but consistency yields the greatest rewards.
Your non-exercise habits matter.
When more variables were included in the analysis, the years of additional life decreased. You can’t exercise away all the negative effects of your bad habits, so change the habits. Consume less alcohol, improve quality and quantity of sleep, reduce career and lifestyle stress as much as possible, etc.
You need to train with purpose.
You don’t achieve the level of fitness in the AULN group by walking around the block. It takes work, but the benefits increase incrementally as you gain fitness. Compared to High Normal CRF, the AULN group (which is about the difference between “recreationally fit” and “training fit), lived 2 years longer.
It’s not just about years.
Most athletes are not training so they can live to 93 instead of 88. You are hoping for a long and healthy life, but the exact number of years isn’t as relevant as what you’re able to do in those years. Training opens up opportunities to say, “Yes!” to more adventures and a wider range of activities.
The long-term benefits of cardiorespiratory fitness aren’t top-of-mind for most goal-oriented athletes. You have an event coming up or a personal accomplishment you’re working toward. But in those moments when you step back and look at the big picture, remember that all the work you’re doing now will pay dividends in the decades to come.
Clausen, Johan S.r., et al. “Midlife Cardiorespiratory Fitness and the Long-Term Risk of Mortality.” Journal of the American College of Cardiology, vol. 72, no. 9, 2018, pp. 987–995., doi:10.1016/j.jacc.2018.06.045.
Interesting that they group people that people who drink 2 units of alcohol every day are grouped in with people that never drink.
Having been a statistician for clinical trials, I am always a bit skeptical of purely observational studies. We need to be careful with deriving causality and making the conclusions that have been made here. I would need to read the study design carefully and understand how the “adjustments” were performed that have been mentioned. It would seem that with the given sample size of just 5000, properly adjusting for all the confounders they mentioned would be rather difficult. It would also be interesting to do a pooled a multi-study analysis to see what different studies tell us and how consistent the findings are. While I don’t doubt that exercising and maintaining great vascular health is a worthwhile goal, I would take the findings here with a grain of salt.
Tengo 63 y una lesión crónica de columna. Llevo 40 años practicando ciclismo y sigo haciéndolo. Los médicos me dijeron que para evitar el dolor debía dejar el deporte y uno de esos médicos que tiene la misma enfermedad que yo tengo y que también monta en bicicleta me dijo que no debía dejar la bicicleta, que hiciera la práctica en forma prudente evitando lesiones y a pesar de mi dolor hago ejercicio 5 dias a la semana, mantengo un peso muy bajo y tengo dietas adecuadas. Espero seguir practicando el ciclismo hasta que la salud me lo permita pero no pienso sentarme en una silla ahora que estoy pensionado, esperando el día de mi fallecimiento. A rodar o practicar algún deporte, no esperen que se haga tarde.
Thank you for the very timely article! I’ll be racing at 69 next season (no woman’s land:) and I do find the older I get, the more stigma and less support there is (fortunately, I have an amazing husband). It’s ironic and sad especially at a time when our healthcare system is in such disarray. We don’t have policies that reward our citizens for healthspan or compression of morbidity. Keep up the great articles! They are appreciated. I’m certain as I approach that 70-75 category, I’ll be looking for a CTS coach to help me with the extra motivation!
I just wrote a feature article on a local athlete who had finished the London marathon in his quest to complete the 6 Marathon Majors. When I asked how he got into running he said, “I didn’t start running until I was 67.” He said running (trails and road races) let’s him “live in denial. I think I’m 35 because I feel better than I did at 35!” When I asked what he attributes to not having been sidelined with injury (he’s now 74 and preparing for Tokyo) he said “I have a theory that because I started much later than my peers, that I don’t have as much wear and tear. I have fresh legs!”
He was a delight to interview and a great person to run into on the trails. He has passion for the sport and I believe that’s a metric that is immeasurable and critical to quality of life at any age! Be excited by an athletic goal!
I like the motto:
I don’t train so that I can race, I race so that I can train.
I ride for the love of it. I get great personal satisfaction out of pushing myself. If I live longer because of it how will I know? Who’s to say what my life expectancy might be without cycling in my life. I only know that at 73 I can still do all the things I want to do and keep up with riders significantly younger than myself. When I compare myself to my peers, I am healthier, stronger, aerobically more fit and seem to enjoy most activities more. I apparently sleep far better than my peers based on informal discussions with them, have a great appetite and am basically stress free….other than fearing I’ll get run over by some distracted driver who didn’t see my despite two rapidly flashing taillights and a headlight. Life is good and much better with cycling in it.
I’m 71. You said everything I wanted to say. I recently worked myself up over my BP and the ER threw me out because they had people that truly had problems. When I said to the physician, “There must be something wrong,” she said, “Mr. Absalom for a man your age you’re in excellent health.”
Every time someone asks me “What are you training for now?” I just like to say “Life”!
I train for the Health of it. 🙂
As Dr Amos says “Res Firma Mitescere Nescit – If You’ve Got It Up, Keep It Up!”
I’d like to see a study where they look at quality of life benefits of exercise. Harder to quantify perhaps but I think that’s what we are all aiming for .
I am a 72 yr old cyclist. A former, competitive runner, tennis player and duathlete. I had a defribulator installed, in 1988, due to an irregular- irregular heart arithmia. I slowly stopped the running and tennis competitions and the duathlons. I’ve continued to be competitive on the bicycle. Last year, I had the defribulator removed and cardiologist appointments moved to every other year, by Doctors orders. The Cardiologist’s comment was,” you’ve stood the test of time, 30 years of NO episodes. You cyclists are beating me all the time. You’ll probably live to be a hundred”. This was the 3rd cardiologist I’ve had as two others had retired. I have a “Farm to Fork” Gran Fondo, Berkshire’s, coming up Sept. 29th, 79 miles, 5,000 feet of climbing and I’m doing the challenges.
Thanks to cycling since I was 10, a family garden my whole life, great Drs, and Carmichael Training, I’m out to beat everyone in front of me. Great article, as usual.
Don’t stop , Dan!
I love how the general statement is in there. “Applies to women too.” Just a blanket statement with no data behind it. I realize that the study was done on all males and probably is related to women somewhat (and it’s not Carmichael’s fault the study was done on males only) still however frustrating that these studies focus on males only.
Sometimes studies are limited to one gender to limit extraneous variables. This is especially true if it’s a pioneering study, which this seems to be. And in general, men are more likely to die of cardiac issues than men.
So hopefully someone will do a follow up study, same methodology, using women.
Did you mean men at more likely to die of cardiac issues than women?
Volunteer to be a subject in any study at your local university or hospital.
I’ve been in the profession since 1976. Title IX passed in 1972, and that’s when girls and women sport participation took off. We have every opportunity to participate, but also to pursue careers in Ex Phys, strength & conditioning, etc.
And as for aging well and moving better for longer, training is a non-negotiable, especially for women; we outlive our male counterparts, but we sure don’t live better.
so here’s the irony for me:
to stay healthy you have to exercise consistently, but most people will not exercise consistently if their only goal is to stay healthy.
My favorite saying now that I’m 59, is “To die young as late as possible.” That pretty much sums it up for me.
David, I like the way you think.
Thanks for presenting a great article. Presented were not just the facts about exercising but also the associated lifestyle impact of our habits. Everything we do is cumulative to our bodies, and can change with change in habits just as stated.
We now know that food is medicine which can change disease as we age to no disease. It isn’t about genetics we are stuck with it is about genetics that we change. Exercise is like the oil and filter change for our bodies to keep it in top functioning condition, we feel better, decreases stress as an outlet for it, and releases happy chemicals. Certainly too is that sleep is cyclic, I sleep better because I exercise, the better sleep supports my exercise and other aspects of my health.
Just as everyone else has shared, I don’t necessarily want to live to be 100, if I live to be 100 I want to do with grace, style, strength, and flexibility and disease free. Everyone here is proof of a positive mind set and will succeed.
“Add years to your life and life to your years.” I’m 57. That’s why I do it. ‘Nuff said!
An outstanding article and really appropriate. I have come to believe all of the “flack” from whatever corner it is coming from about mid-life crisis, recapturing your youth, etc. is just misdirection and jealousy. The data speaks for itself but importantly you hit on what I suspect is the key point for most of the middle-aged athletic crowd, quality of the years vs. some unknown quantity. I have been running for 35+ years and continue to enjoy it, why quit? The challenge of ultra’s is something very personal and enjoyable, if it wasn’t I simply would not do it. While the events and racing are fund and challenging the activity, training and simply time outside and with friends is the quality component that I simply enjoy the most. I have adopted an adage as I have moved along my athletic career, “I like to race/compete, but I LOVE to run!” That pretty much says it all and your focus on quality is one of the many reasons I enjoy your blog, point of view and CTS. Enjoy the ride, there really are no dress rehearsals, retakes or do-overs in life – make the most of it.
Thank you for the kind words and speaking the truth 🙂
Chris: I couldn’t agree more. In my late 50’s I was diagnosed with an episode of atrial fibrillation that really woke me up. I thought I was in pretty good shape (enough to do the occasional century ride) but I was clearly over-weight and over-stressed. Through a two year progression of weight loss through a carb-light, protein and vegetables heavy diet, watching of stress factors, and commitment to a program of really working out effectively at least 5 days a week, I managed to not just lose 35 lbs, but gain substantial fitness. Notwithstanding what we see advertised about focusing on weight rather than aerobic training, I focused on both and focused on doing aerobic events on the bike that for days at a time kept my Strava fatigue scores (see below) well over 100, followed by two to three rest days and then another ramp. I’m now 62 but had a recent VO2 Max test that resulted in a 23 MET, 80.3 ml/kg/min result that I was pretty happy with.
One lesson I learned along the way was to really watch my Freshness and Fitness data on Strava, working too hard actually caused me to gain weight and just tire my heart, gradually building up the training load, taking a few days easy and then ramping up again made a huge difference. Being careful about both training and diet does allow you to retain a very high level of fitness not just at 40 or 50 but even well into your 60’s.
JD: I also focus more on recovery now. It seems like it take longer between hard rides to bounce back. The normal 24hrs of recovery after a hard ride now is 48 or 72hrs…
Thanks for the tips, enjoy the ride.
My story at 63 is almost identical – one a-fib episode that gave me the wake up I needed. The fix was 1) lose weight through better diet, 2) reduce stress and improve sleep, and 3) stop doing hardcore weekend rides and focus instead on riding at least 5 days a week at lower intensity and watching freshness and fitness. After all that I recently qualified to ride in my first world championships in 40 years.
I am 77 yo and have been cycling for over 30 years as well as rowing indoor and ocean kyak fishing up until last summer. Last October I was diagnosed with endstage prostate cancer and given 2-3 weeks to live. My hgb had dropped to 6 and Hct to 20. If it wasn’t for my fitness (resting bp 42) I would not have survived the first week.
My Drs did a great job in by me time. On January I started back on my indoor cycling and my indoor rowing. It made me feel so much best. There are studies showing that Cancer patients do better if they exercise during treatment. I am back at work. In June I learned that the cancer physicians were having a biking event to raise money for cancer. To that point my longest ride was 25 miles. I decided at that point that I was going to participate. They had a 25 mi/ 50mi and 100 mi ride. The ride was just 4 weeks later. Since I knew that I could ride 25 miles I decided to enter the 50 mile ride. Based on previous training I knew that I could succeed. As I began to train I found that definitely do 50 and possibly more. I then decided to aim for the 100. I told every one that I was going to ride the 100 mi. That put pressure on my to train for the 100.
The day of the ride came and almost all the rider lining for the 50 & 100 were no older that 60.
I was determined to finis the ride.,
I did finish the ride. I was the last one in by far. It took me almost 9 hours on a very hilly route but I finished. Exercise definitely played a big role in my recovery.
Ralph: Great story and thanks for sharing. The message here is “you can many times do more than you think”. Nice job, keep it going!
As a 70 year old female cyclist, who battled Lupus and won, I loved your story. It amuses me that 50 year olds are referred to as older cyclists. I climbed Mt Ventoux this July, not on an E bike, but an H bike. H bike? Heart powered😊
Great article. The consistent and admittedly sometimes not consistent process of my training to reach goals enriches my life daily. I need it, plus the longer term health benefits are a plus.
We all need to keep with it and taking large breaks (weeks) isn’t helpful. So let’s stay on it full time, full gas as there is where we make our gains.
Be sure and get a complete stress test before starting your exercise program. I got away without it but it was a close call and I was lucky. I do agree with the scientific findings once you get the green light to proceed:)
Good reminder on the stress test. The science backs up what many of us knew for years…:)