Which Sport Helps You Live Longest? (A League Table of Sports)

Sport, exercise and longevity

There is no doubt exercise is good for you. A meta-analysis open_in_newcitation of over one million people found a 24% reduction in all-cause mortality between the least and most intensive physical activity groups. Similarly, the UK Biobank study followed half a million participants and found being physically active at 45 years was associated with seven additional survival years in those with chronic illness open_in_newcitation.

Recent data also suggests that physical activity helps preserve telomere length. In the study by Cherkas (2008) open_in_newcitation, people who were less physically active during their leisure time had shorter telomere lengths than those who exercised regularly, with a difference approximating to 10 added years.

emoji_events Survival of Professional Athletes

In a recent blog, we found 24 studies open_in_newcitation showing that athletes lived longer, with a 49% risk reduction, and had reduced incidence of both cardiovascular disease and cancer mortality compared with non-athletes.

Lemez and Baker (2015) found that basketball players, NFL players, cyclists, NBA players and golfers had the most robust evidence of greater longevity.

Runacres and colleagues re-examined outcomes in 165,000 athletes open_in_newcitation. Athletes lived significantly longer than the general population: male SMR 0.69 and female SMR 0.51. There was no survival benefit for male power athletes compared with the general population.

From these studies, the typical longevity benefits were +4 years for marathon runners, +8 years for Tour de France cyclists and +6 years for Olympians involved in endurance sports. But as these are all based on elite athletes, I want to know whether this effect exists in regular people doing regular sports, and which sport comes out on top.

speed A Caution About Intensity

Although I have previously tried to debunk the J-shaped survival curve, I do agree that really tough sports like marathon running are probably not optimal for longevity. Not, I repeat, because of a J-shaped survival curve, because if you can do them, you will benefit. Rather, these sports are too hard to maintain in later life. OK, some manage it, but let us be honest: most give up after their junior years. So it remains possible that golf or table tennis may beat CrossFit in the long term. After all, you get a progressive survival benefit the more steps per day you do, as shown in this 2022 study replicating the old 2014 Harvard Alumni study.

Another way to simplify this blog is to find which sport gives you the most additional steps over a lifetime, not necessarily the most steps this year.

Before going too deep into this, let us start with this question: what is exercise?

fitness_center What Is Exercise?

Exercise could mean mowing the grass, or it could mean running 800 m at the Olympics. Exercise is essentially activity that is physically tough. If you want to be precise, let us define it as activity that raises the heart rate to 50% of heart rate reserve (HRR = HRmax – HRresting). If it is organised and has rules, we call it a sport.

Sports differ radically from easy to ridiculously hard. But they also differ in other key ways that become important over the long term, namely:

Sustainability = how hard it is to keep doing them long term.

Sociability = how much they involve group participation.

It turns out these factors are key for determining the long-term health benefits of sports. Look at it like this: you could take up rugby at the age of 20. Great! You will get a lot of physical benefits and the added value of team culture. But how long will you continue? Until 35? 45? With such a tough, high-impact sport, almost no one plays beyond 35.

So perhaps you gained 15 years of benefit, but once you gave up or got injured, you lost out on all subsequent years. To say this another way, you got 10 years of benefit but 50 years of effective deterioration in retirement. Sure, you can start something else; however, I am trying to assess the benefit of participating in that one sport relative to others. So if you compare sport participation over a lifespan, it might look like this:

Right, now it is time to dig into what the research says on this topic.

query_stats Participation in Which Sport Is Optimal?

Oja et al. (2016) open_in_newcitation was one of the first studies to look at this in a large sample of 80,306 British adults. Significant reductions in all-cause mortality were observed for participation in cycling (HR = 0.85, 95% CI 0.76 to 0.95), swimming (HR = 0.72, 95% CI 0.65 to 0.80), racquet sports (HR = 0.53, 95% CI 0.40 to 0.69) and aerobics (HR = 0.73, 95% CI 0.63 to 0.85). No significant associations were found for football or running.

Results from the 25-year Copenhagen City Heart Study (CCHS) in Mayo Clinic Proceedings, after tracking more than 8,500 people, found that these sports and activities increased life expectancy for active participants the most compared with sedentary peers:

• Tennis: 9.7 years
• Badminton: 6.2 years
• Football: 4.7 years
• Cycling: 3.7 years
• Swimming: 3.4 years
• Jogging: 3.2 years
• Calisthenics: 3.1 years

Sheehan and Li (2020) open_in_newcitation followed 26,727 American adults in the National Health Interview Survey from 1998 for 17 years. The best exercise in terms of unique contribution was volleyball, followed by aerobics and running. They also looked at participation. Walking (48%) and stretching (30%) were popular, followed by weight lifting (17%), cycling (14%) and running (12%), but most other sports had lower engagement.

Watts and colleagues (2022) followed a quarter of a million elderly people in the National Institutes of Health AARP Diet and Health Study for 15 years. In this study, the optimal sports were running (hazard ratio = 0.85), racket sports (HR = 0.84), then walking, golf, aerobics, swimming and cycling open_in_newcitation.

In the Malmö Diet and Cancer Study cohort open_in_newcitation, Bergwall and colleagues (2021) looked at 25,876 people with a 21-year follow-up. In terms of cardiovascular mortality, the top sports were orienteering, running, tennis, golf and dancing. Individuals who reported that they had stopped at the five-year follow-up still had a lower risk than those who had never participated in physical activities, but the lowest risk was observed for those categorised in the continued group at the five-year follow-up. Continuing your chosen activity into later life is the gold standard.

One activity that is confusing in its benefits or hazards is gym strength training. A new meta-analysis from Momma and colleagues (2022) examined 16 individual studies open_in_newcitation. Overall, muscle-strengthening activities were associated with a 15% lower risk of all-cause mortality. But there was a catch. For this sport, a J-shaped association was found between muscle-strengthening activities and all-cause mortality, cardiovascular disease and total cancer, with the maximum risk reduction, approximately 10-20%, at approximately 30-60 minutes per week of muscle-strengthening activities.

format_list_numbered Bringing the Story Together: A League Table

Historically, humans lived in tight-knit social hunter-gatherer groups where people looked out for one another. Modern society has given us a different and inferior model, in which we outsource care for vulnerable and elderly people to care facilities and nursing homes where anonymous professionals are paid to look after our relatives. As many as 70% of elderly people need care, and although many families help, the proportion of families that do help appears to be falling open_in_newcitation.

The bottom line is that we are increasingly isolated, especially in later years, and this is strongly linked with higher mortality. Data from 27 studies involving 1.30 million individuals shows that social isolation increases all-cause mortality by 33%. Risk is higher in men than women and in younger than older individuals.

This is why social sports such as dancing, badminton, football, golf, softball, basketball and tennis are usually superior to activity completed alone, including swimming, cycling and jogging over the long term open_in_new19 open_in_new47 open_in_new69 open_in_new73. Social sports also help maintain motivation, especially outdoors open_in_new72.

With this in mind, I made this league table of the most helpful sports that promote longevity:

As you see, at the top are dancing, badminton, tennis, football, cycling and trekking or fell-walking. At the bottom are running, table tennis, squash, CrossFit and rugby.

My take-home message is this: starting any sport is good, but continuing a sport long term, ideally lifelong, is the golden ticket. You do not have to stick in your lane. You can mix up any combination, learn new skills and meet new people by trying a new sport every few years.

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