Running as a Key Lifestyle Medicine for Longevity

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Abstract

Running is a popular and convenient leisure-time physical activity (PA) with a significant impact on longevity. In general, runners have a 25%–40% reduced risk of premature mortality and live approximately 3 years longer than non-runners. Recently, specific questions have emerged regarding the extent of the health benefits of running versus other types of PA, and perhaps more critically, whether there are diminishing returns on health and mortality outcomes with higher amounts of running. This review details the findings surrounding the impact of running on various health outcomes and premature mortality, highlights plausible underlying mechanisms linking running with chronic disease prevention and longevity, identifies the estimated additional life expectancy among runners and other active individuals, and discusses whether there is adequate evidence to suggest that longevity benefits are attenuated with higher doses of running.

Section snippets

Longevity benefits of running

There are several large population-based cohort studies, which have examined all-cause mortality and other health outcomes among runners compared with non-runners.17., 19., 20., 21., 22. Overall, these studies found that after adjusting for age and sex, runners have 30%–45% lower risk of all-cause mortality. After further controlling for smoking status, alcohol consumption, socioeconomic variables, body mass index (BMI), and other types of PA, the impact of running on reducing all-cause

Is running more important for longevity than other lifestyle and health risk factors?

The WHO has reported that 6% of premature mortality is related to physical inactivity.25 Another recent review indicated that physical inactivity causes 9% of all-cause mortality worldwide.1 Physical inactivity has been cited as the 4th leading global risk factor for death, especially in middle-to-high income countries, after high blood pressure (BP) (1st), cigarette smoking (2nd), and high blood glucose (3rd).25 Overweight/obesity and high cholesterol were found to be the 5th and 6th leading

Potential mechanisms linking running to health outcomes

There are many purported mechanisms through which running may reduce premature mortality (Fig 3). Numerous epidemiological studies have reported associations between running/vigorous exercise and improvements in various chronic disease risk factors, including HTN, dyslipidemia, body composition, insulin sensitivity, blood glucose regulation, disability, bone mineral density, and CRF.27., 28., 29., 30. Running/vigorous exercise may reduce some types of cancer-related mortality (e.g., breast and

Is running better than other types of PA for longevity?

One of the most commonly asked questions regarding PA and health is simply, “What type of exercise or PA is the best for health?” Likewise, because running is so popular and convenient, people are often curious about whether or not running is better than other types of exercise or PA. We conducted a simple joint stratification analysis to address this question using the Aerobics Center Longitudinal Study (ACLS) data. We dichotomized both leisure-time running and other PA except running into two

How much longer can runners live?

Most cohort studies automatically adjust for age in their analyses, but data from age-group separated analyses indicate that mortality outcomes are not only similar among young (<50 years) and old (≥50 years) runners, but that longevity benefits are clearly the greatest among those who continue to run throughout their lives.17., 19. Unfortunately, running participation declines with age. Twenty to 30% of 18–29 year olds indicate that they run or jog in their free time. Running participation

Is there too much running for longevity?

Some recent studies suggest that excessive endurance exercise (EEE), such as habitual running, may cause adverse effects on cardiac structure and function.27., 49., 50., 51., 52., 53. Some postulated mechanisms linking EEE to potential adverse cardiac effects include increased vascular oxidative stress and inflammation, myocardial fibrosis, and structural changes in the heart and its autonomic control.50., 54., 55., 56. A study on 52,755 participants in the Vasaloppet 90 km cross-country ski

Potential upper threshold for longevity benefits of running

It is too early to conclude that large amounts of running have adverse health effects. There is, however, benefit in providing a cut point for an effective and safe amount of running as a guide. We used the ACLS data62 to identify potential upper limits of running beyond which additional running provided no further mortality benefits, although there was also no excess risk of harm (Table 1).

These potential benefit thresholds are similar to findings from other large cohort studies on the

Conclusion

There is compelling evidence that running provides significant health benefits for the prevention of chronic diseases and premature mortality regardless of sex, age, body weight, and health conditions. There are strong plausible physiological mechanisms underlying how running can improve health and increase longevity. Running may be the most cost-effective lifestyle medicine from public health perspective, more important than other lifestyle and health risk factors such as smoking, obesity,

Statement of conflict of interest

None of the authors have any conflicts of interests with regard to this publication.

References (69)

  • P. de Souto Barreto et al.

    Physical activity and cognitive function in middle-aged and older adults

    Mayo Clin Proc

    (2016)
  • C.J. Lavie et al.

    Impact of cardiac rehabilitation and exercise training on psychological risk factors and subsequent prognosis in patients with cardiovascular disease

    Can J Cardiol

    (2016)
  • J. Myers et al.

    Physical activity and cardiorespiratory fitness as major markers of cardiovascular risk: their independent and interwoven importance to health status

    Prog Cardiovasc Dis

    (2015)
  • L.F. DeFina et al.

    Physical activity versus cardiorespiratory fitness: two (partly) distinct components of cardiovascular health?

    Prog Cardiovasc Dis

    (2015)
  • P.T. Williams

    Usefulness of cardiorespiratory fitness to predict coronary heart disease risk independent of physical activity

    Am J Cardiol

    (2010)
  • K.I. Erickson et al.

    Physical activity, fitness, and gray matter volume

    Neurobiol Aging

    (2014)
  • C.P. Wen et al.

    Minimal amount of exercise to prolong life: to walk, to run, or just mix it up?

    J Am Coll Cardiol

    (2014)
  • C.P. Wen et al.

    Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study

    Lancet

    (2011)
  • W. Bouaziz et al.

    Health benefits of aerobic training programs in adults aged 70 and over: a systematic review

    Arch Gerontol Geriatr

    (2017)
  • P.T. Williams et al.

    Increased cardiovascular disease mortality associated with excessive exercise in heart attack survivors

    Mayo Clin Proc

    (2014)
  • D.C. Lee et al.

    Optimal dose of running for longevity

    J Am Coll Cardiol

    (2015)
  • R. Shave et al.

    Exercise-induced cardiac troponin elevation

    J Am Coll Cardiol

    (2010)
  • J.H. O'Keefe et al.

    Exercising for health and longevity vs peak performance: different regimens for different goals

    Mayo Clin Proc

    (2014)
  • D.C. Lee et al.

    Running and mortality: is more actually worse?

    Mayo Clin Proc

    (2016)
  • P.T. Williams

    Reductions in incident coronary heart disease risk above guideline physical activity levels in men

    Atherosclerosis

    (2010)
  • T.M.H. Eijsvogels et al.

    Exercise at the extremes

    J Am Coll Cardiol

    (2016)
  • G. Samitz et al.

    Domains of physical activity and all-cause mortality: systematic review and dose–response meta-analysis of cohort studies

    Int J Epidemiol

    (2011)
  • I.M. Lee et al.

    Associations of light, moderate, and vigorous intensity physical activity with longevity. The Harvard Alumni Health Study

    Am J Epidemiol

    (2000)
  • E.J. Shiroma et al.

    Do moderate-intensity and vigorous-intensity physical activities reduce mortality rates to the same extent?

    J Am Heart Assoc

    (2014)
  • World Health Organization

    Global recommendations on physical activity for health

  • Physical Activity Guidelines Advisory Committee

    Physical Activity Guidelines Advisory Committee

  • Centers for Disease Control

    Facts about physical activity

  • R.P. Troiano et al.

    Physical activity in the united states measured by accelerometer

    Med Sci Sport Exerc

    (2008)
  • S. Dai et al.

    Participation in types of physical activities among US adults—National Health and Nutrition Examination Survey 1999–2006

    J Phys Act Health

    (2015)
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    Statement of Conflict of Interest: see page 53.

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