Doctors Explain the Best Way to Exercise for Longevity

The Physical Activity Guidelines for Americans recommend getting at least 150 minutes of moderate-intensity aerobic activity every week, along with two days of muscle-strengthening activity. But data suggest that while nearly half of American adults meet the aerobic activity recommendations, less than 25% do both aerobic exercise and strength training. Now, new research underscores why it’s so important to combine the two.

The study, which was published in the British Journal of Sports Medicine, analyzed data from more than 147,000 adults who participated in three long-term studies: the Health Professionals Follow-up Study, the Nurses’ Health Study, and the Nurses’ Health Study II. The participants answered questions about their weekly aerobic exercise and strength-training regimen every two years for up to 30 years.

After analyzing the data, the researchers found that people who engaged in strength training for 90 to 120 minutes a week had a 13% lower risk of dying from any cause during the study period, as well as a 19% lower risk of dying from cardiovascular disease and a 27% lower risk of dying from neurological disease. There was no additional benefit to doing more than 120 minutes a week.

Crucially, though, mortality risk was lowest for those whose weekly routines included both aerobic activity and 60 to 119 minutes of resistance training.

“The biggest takeaway is that this study supports something we’ve been recommending for years: Adults should do both aerobic exercise and resistance training,” says Caitlyn Mooney, M.D., assistant professor in the department of orthopedic surgery at Vanderbilt University Medical Center.

Below, experts break down why these types of exercise are associated with longer lifespans.

Meet the experts: Yiwen Zhang, Ph.D., lead study author and postdoctoral researcher in the Department of Nutrition at Harvard T.H. Chan School of Public Health; Edward Giovannucci, M.D., study co-author and professor at Harvard T.H. Chan School of Public Health; Caitlyn Mooney, M.D., assistant professor at Vanderbilt University Medical Center; Christopher V. Wilhelm, M.D., orthopedic surgeon at Northwell Orthopedics in Westchester; Albert Matheny, R.D., C.S.C.S., co-founder of SoHo Strength Lab; Clarinda Hougen, M.D., primary care sports medicine specialist at Cedars-Sinai Orthopaedics and team physician for Angel City FC; Dennis Colón, P.T., D.P.T., founder of FisioPR; Lori Diamos, P.T., physical therapist and founder of Pearls from a PT.

What’s behind the link?

The study didn’t prove that this combination of resistance training and cardio exercise helped people live longer—it only found a link. Still, experts say it’s worth paying attention to.

“Resistance training may support longevity through several pathways,” says Yiwen Zhang, Ph.D., lead study author and postdoctoral researcher in the Department of Nutrition at Harvard T.H. Chan School of Public Health. In addition to strengthening your muscles, lowering your body fat, improving how well your body uses blood sugar, and boosting your physical function, “it may also help preserve independence, reduce frailty, and improve mental health and quality of life, especially in older adults,” Zhang says.

Lori Diamos, P.T., physical therapist and founder of Pearls from a PT, seconds the notion that strength training helps with day-to-day life. “As a physical therapist, I see the real-world impact every day,” she says. “Muscle isn’t just about looking toned. Muscle gives us strength, stability, control, balance, and power.”

Christopher V. Wilhelm, M.D., an orthopedic surgeon at Northwell Orthopedics in Westchester, touts the less obvious benefits of strength training, such as improving sleep quality and reducing depression and anxiety. Dr. Wilhelm is also intrigued by the evidence linking strength training to reduced risk of death from neurological disease. He believes this may have something to do with signaling molecules called myokines, which are released during muscle contractions. “[Myokines] appear to cross into the brain and protect nerve cells, though that area of research is still developing,” he says.

Of course, the benefits of strength training are strongest when combined with aerobic exercise, which has its own perks, such as boosting metabolic health, reducing blood pressure, and improving circulation. “Physical activity is not one single behavior,” says Edward Giovannucci, M.D., study co-author and professor at Harvard T.H. Chan School of Public Health. “Aerobic activity and resistance training may benefit health through different pathways, so it is important to study them separately and together,” he says.

How to incorporate strength training into your workout routine

Many Americans aren’t exercising enough overall, but most fall short when it comes to strength training.

If strength training isn’t part of your current exercise routine, Albert Matheny, R.D., C.S.C.S., co-founder of SoHo Strength Lab, suggests trying strength training for 20 to 30 minutes on non-consecutive days of the week. “Then, you can get to those [target] numbers pretty easily,” he says.

To start, try doing “simple bodyweight exercises,” says Clarinda Hougen, M.D., primary care sports medicine specialist at Cedars-Sinai Orthopaedics in Los Angeles and team physician for Angel City FC. Simple moves like squats, step-ups, modified push-ups, and planks “are highly effective,” she says.

As your strength improves, you can add on light weights like dumbbells or kettlebells, or use resistance bands to challenge yourself more.

“You can use a variety of equipment; a gym isn’t necessary,” says Dennis Colón, P.T., D.P.T., founder of FisioPR. “Slowly increase your sets and reps over time. The amount needed to see important benefits is lower than many think.”

Experts stress that strength training is doable for most

Dr. Wilhelm points out that the study found the benefits of resistance training plateaued after 120 minutes a week. “There’s a clear sweet spot, and it’s more achievable than people might expect,” he says.

Dr. Mooney agrees. “The headline isn’t that everyone needs to become a powerlifter,” she says. “It’s that two reasonably structured strength-training sessions per week, combined with regular aerobic exercise, may provide meaningful long-term health benefits.”

Colón expresses a similar sentiment, but adds an important caveat: While 90 to 120 minutes is “ideal” for strength training, “any amount is better than none.”