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. A new study adds even more evidence that the training you do in your 40s and 50s can add years to your life and life to your years.
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
By March of 2017, 92% of the men had died, and 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.
|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|
I was most interested in the Above Upper Limit of Normal (AULN) group, because the VO2 max values are similar to what we often 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 I think 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 I would expect the trend lines to 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. To be honest, I’m not training so I can live to 93 instead of 88. I’m hoping for a long and healthy life, but the exact number of years isn’t as relevant as what I’m 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.