How Middle-Aged Athletes Can Add 5 Years to Their Lives

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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 typeCause of DeathLow Normal CRFHigh Normal CRFAbove Upper Limit of Normal CRF
Age onlyAll-Cause mortality+3 years+4.2 years+6.4 years
MultivariableAll-Cause mortality+2.1 years+2.9 years+4.9 years
Age onlyCardiovascular mortality+3.3 years+4.4 years+6.7 years
MultivariableCardiovascular 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.

  1. Applies to women, too! Although the study itself used data from an all-male cohort, it is hard to believe the results would be much different for women. Perhaps the values used to create VO2 max categories would be different, but I would expect the trend lines to be very similar.
  2. 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.
  3. 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.
  4. 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.
  5. 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.


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Comments 13

  1. Chris,

    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.

  2. 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.

    1. 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.

  3. 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.

    1. 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!

  4. 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.

    1. Bill:
      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.

  5. 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:)

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