How to Live Until 90

exercise and live to 90

Survival curves in men (left) based on low or high exercise capacity. Curves for women (right) based on WBC count.

Many epidemiological studies have looked at various biomarkers to see how they are related to health. Perhaps the most familiar biomarker is total cholesterol level – although the doctors got that one wrong, since higher cholesterol is associated with lower total mortality in men, as can be seen in the following chart:

But the fact is, cholesterol isn’t a great predictor of mortality. So what is?

Exercise may be the single best predictor of long life

It turns out that exercise capacity is one of the best, if not the best, predictors of mortality in men. The higher your exercise capacity, the longer you’ll live. This is very good news, because you can always modify, that is, increase, your exercise capacity.

A meta-analysis that was published in the Journal of the American Medical Association looked at the relation between cardiorespiratory fitness and total and cardiovascular mortality. Cardiorespiratory fitness (CRF) was classified according to maximal aerobic capacity and measured as metabolic equivalent units.

Metabolic equivalent units, or METs, are a measure of exercise capacity. One MET is the amount of energy expended sitting quietly. (The precise definition is of course more technical.) Jumping rope comes in at around 11 METS. The people in the study were classified as to number of METs they were capable of in an exercise stress test, meaning maximal capacity.

Those with low CRF had a 70% greater chance of dying at any given age than did those with high CRF.

How to live until 90: exercise

Another recent study wanted to discover what helped men and women live to old age, from the starting age of 75, to the age of 90 to be precise: How to live until 90 – Factors predicting survival in 75-year-olds from the general population. This study found that in men (but not in women), exercise capacity was the single largest factor in predicting survival from the age of 75 to the age of 90.

We report multiple factors that, both individually and jointly, predict survival until 90 years of age among 75 year-old community-dwelling residents from a defined geographical area. The most interesting finding, especially among men, was the strong association between survival and results from the exercise test, including high exercise capacity as measured by MET, high HRR after 4 minutes recovery, and high systolic BP rise during exercise. The prognostic importance of these factors greatly exceeded that of common prevalent diseases such as diabetes, hypertension, asthma, and angina pectoris/previous MI as well as that of conventional risk factors such as smoking, high BP, high level of TC, low level of HDL-c and obesity. Furthermore, both MET and HRR were significantly related to both shorter (10 year) and longer (10 to 15 year) survival.

For every one standard deviation increase in exercise capacity, the men had about a 60% lower chance of dying.

The authors don’t shy away from noting that traditional risk factors such as cholesterol seem to be far less important than exercise capacity.

The strongest predictive factor among men, exercise capacity, is clearly modifiable by physical activity, which then can improve both survival and quality of life. In contrast, traditional risk factor interventions such as the reduction of cholesterol levels and BP seem to be less important. Furthermore, exercise capacity clearly exceeds the importance of several established diseases to life expectancy. Therefore, a physically active lifestyle could compensate well for the prognostically adverse effects of such diseases. Taken together, the results of this analysis are important for preventive health care among the elderly.

The lesson here is clear: if you want to live to an old age, get moving and increase your exercise capacity.

I often get the response when I discuss extending lifespan that it’s better to live a full life without concerning oneself too much about long life.  But aging means by definition more illness and disease. So if you’re only concerned about being healthy and avoiding the nursing home, you too need to exercise.

PS: Check out my Supplements Buying Guide for Men, and my guide to anti-aging, Stop the Clock.


Leave a Comment:

Andrew says June 24, 2015

What would you say is the best way to gauge your exercise capacity? I’m 25 and aim to increase my strength and speed every year. At what age might I see this start to decline? (or at least be ok with it starting to decline!)
Excuse my ignorance, but I just found your site, and am excited to dig further into your readings.

    P. D. Mangan says June 24, 2015

    Andrew, it’s not ignorance at all, it’s a good question. In both of those studies, exercise stress tests were used, meaning a laboratory measurement of maximum exercise capacity. Short of paying for one (or several), personal best times or lifts may help you gauge exercise capacity. Exercise capacity probably declines starting by one’s late 20s, which can be seen in professional athletes. For most of us, it might not be very noticeable though, provided we keep up exercising. (I base this on the fact that both muscle mass and bainpower have been shown to be lower in the decade of the 30s; it stands to reason that virtually all physical and mental powers are declining by then.) If you at age 25 were competing at something, running, say, against an 18-year-old, the difference might be noticeable.

    Hope you find some things of value on the blog.

      @Joe_E_O says November 22, 2015

      The three strategies I use to increase my work capacity:
      1) I ALWAYS super-set or tri-set my workouts. This means instead of doing 3-5 sets of one exercise. then 3-5 of a second and so on – I do one set of one exercise, then a set of a second exercise and then a set of a third. Typically I do a set of a squat, a press, a row for 3-5 sets – and then to a set of DL, a two accessory exercises. This always (forces) you to fit more work into your workout in the same amount of time.
      2) I track the total amount of weight I lift for the ENTIRE work out – because I keep the exercises and time constant – tracking the total amount of weight lifted (setsXrepsXweight) gives some guidance as to the total amount of “work” I did in the workout
      3) Doing steady-state aerobic exercise on my off/recovery days does seem to increase my work capacity (though probably not my 1 rep max for any given exercise)



jer says June 26, 2015

Can you give any advice to a non responder endormorph? do you have reasons to think the regimen you suggest would not work?

Best of luck with the new book!

    P. D. Mangan says June 26, 2015

    jer, I don’t think I have a magic bullet for that. Work out hard, compound lifts, eat plenty with lots of protein, take whey around workouts. You might try creatine, as well as BCAA/leucine with meals.

      jer says July 8, 2015

      ok thought you’d say that. que sera.

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