Article by Larisa Dina who is a researcher finishing her PhD at King’s College London. Larisa is writing exclusively for the Purposeful Group companies of which we are a part, and is an expert on digital health.

The benefits of reducing sedentism and engaging in more physical activity are well-replicated. In a previous blog, I shared how aiming for 7,000 to 10,000 steps most days supports longevity and reduces chronic disease risk. Since then, a new large-scale study was published in BMJ Medicine, adding important nuance to the discussions around exercise.

Why is this study worth talking about?

Few studies to date have looked at the comparative effects of different types of exercise on disease risk. We knew that more exercise is typically helpful, but considering the wide variety of activity types and classes available, is there a single type of activity that is worth prioritising? Is it a good idea to mix different activities? Is there such a thing as a general ‘exercise effect’ that acts as a panacea across the board, and irrespective of the exact activity type?
In said study, researchers tracked over 111,000 adults without any major diseases across approximately 30 years, recording not only how much physical activity participants did, but also the types of activity they engaged in, from walking, running, cycling and climbing flights of stairs to racquet sports and resistance training.

What did they find?

1) One of the main findings was that most individual activities - including walking, jogging, running, tennis/squash/racquetball, stair climbing, rowing or calisthenics and weight training - were associated with a lower risk of death from any cause. The only activity not associated with lower all cause mortality was swimming.

2) Another important finding of the study is that aerobic (e.g., running, jogging), resistance training (e.g., weight training) and activities combining complex movements (e.g., racquet sports) are not interchangeable. In other words, they showed different associations with mortality, supporting the idea that these activities exert their beneficial effects through different pathways and that there isn’t a blanket ‘exercise effect’.

3) However, arguably the most novel and important finding of the study was that participants who regularly engaged in a greater variety of different physical activities had a significantly lower risk of death from any cause (a reduction of approximately 19%). Crucially, this protective effect remained even after accounting for how much total movement people engaged in. In other words, engaging in multiple types of exercise appears to provide added benefits even after accounting for total activity volume.

Why might engaging in different types of activity be beneficial?

There are a few possible reasons to explain this result:

1) Different activities stimulate different bodily systems. Aerobic exercises like walking or running improve cardiovascular fitness, resistance training boosts muscle strength and bone health, while sports like tennis engage coordination and agility.

2) It keeps engagement up. Doing a broader range of activities may simply make exercise more interesting, increasing long-term adherence which is essential for sustained health benefits.

This aligns with other evidence showing that combining aerobic and resistance training provides better outcomes for physical function than either alone.

Some limitations to consider

This study presents associations rather than causation. Physical activity was self-reported through a questionnaire, and not all types of activity were assessed at all time points (notably, weight training was introduced later). Something important to note which may relate to swimming in particular (for which the study didn’t find a significant association with all cause mortality) is that the study didn’t have information on the intensity of the activities reported. This means that the true energy expenditure during these activities, especially for activities such as swimming, may have been misclassified.

Practical takeaways

For many professionals balancing demanding careers, travel and family life, finding time to exercise consistently can be a challenge. The good news is that the evidence to date, albeit observational and with the limitations noted above, supports flexible, varied approaches. Based on individual ability and preferences, this may look like keeping walking as a foundational movement every day, and adding a couple of sessions of resistance training and mixed-skill activities into our weekly routines.

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