COMMENTARY

Physical Activity and Longevity: Which Sport Is Best?

Tom G. Bartol, MN, NP

Disclosures

April 23, 2019

Are All Physical Activities Equally Beneficial?

Physical activity is good for health, but does it matter which activity a person engages in? New evidence suggests that it does, and we have a winner.

Investigators analyzed data from the long-term Copenhagen City Heart Study.[1] This prospective population cohort study, initiated in 1976, followed 8577 white participants for 25 years to assess various aspects of cardiovascular health. A recent analysis looked at various types of physical activity and all-cause mortality.

Sedentary people were compared with those who reported physical activity primarily in the following sports: tennis, badminton, soccer, jogging, cycling, low-intensity calisthenics (referred to as "gymnastics"), swimming, and health club activities (which included treadmill, elliptical trainer, and weight training) (Table).

Table. Life Expectancy Gains, by Leisure Sport Activity

Activity Years of Life Gained
Tennis 9.7
Badminton 6.2
Soccer 4.7
Cycling 3.7
Swimming 3.4
Jogging 3.2
Low-intensity calisthenics 3.1
Health club activities 1.5

Tennis players had the highest average education levels, household incomes, and alcohol intake. The mean age of participants was highest among those doing calisthenics, with swimming and cycling close behind. Cyclists spent more than twice as many minutes per week on their leisure physical activity compared with other sports. Sports that require two or more individuals to play together and socially interact (tennis, badminton, and soccer) were the sports associated with the highest gains in life expectancy.

Every type of physical activity was associated with longer life expectancy compared with being sedentary. These data don't prove causal relationships. But physical activity does seem to be strongly associated with improved life expectancy.

Viewpoint

With such a focus on numbers (blood pressure, cholesterol, and blood glucose) and medications in health, we may be missing out on the real key to a healthy life. As an avid tennis player, I was happy to read this article. It is consistent with what I see when I am playing tennis—70- and even 80-year-olds still playing tennis, some of them beating me! They are not as quick as they used to be, but they take pleasure in getting together several times a week with their friends to play tennis.

Is it the tennis that helps them to live such a healthier and longer life, or the socializing involved in playing a sport with others? Perhaps tennis simply gives meaning and purpose to their lives. Alternatively, the higher average income and education level could be factors associated with longevity.

In the Copenhagen study, tennis players and joggers had the lowest systolic blood pressure and the lowest cholesterol levels and took the fewest blood pressure medications. Are healthy people more active, or does activity lead to better health?

Ten years ago, the EPIC trial looked at data from more than 23,000 Germans aged 35 to 65 years.[2] The study evaluated four factors related to health: 1) never smoking, 2) body mass index (BMI) below 30 kg/m2, 3) performing 3.5 hours of physical activity per week, and 4) adhering to a healthy diet (high intake of fruits, vegetables, and whole grains, and low meat consumption). It found that people who adhered to all four factors had a 93% lower risk of developing diabetes, 81% lower risk for heart attack, 50% lower risk for stroke, and 36% lower risk for all cancers. Simply maintaining a BMI lower than kg/m2 resulted in a cumulative 67% reduction in these chronic diseases.

When we prescribe a medication, patients believe they need it. They may not realize that they could gain the same benefits with lifestyle modification. Stopping or avoiding a medication is a motivating factor that we don't use often enough.

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