Staying physically active has long been recognised as one of the pillars of a healthy lifestyle, alongside balanced nutrition, adequate sleep, stress management and avoiding tobacco. 

While the benefits of exercise for longevity are well established, questions have remained about which types of physical activity are most effective in extending life. New research now suggests that variety, rather than a single preferred routine, may be the key.

A large study published in BMJ Medicine has found that regularly engaging in a wide range of physical activities—such as running, cycling, swimming, strength training and even outdoor work—is associated with a lower risk of premature death.

According to the researchers, people who mix different forms of exercise into their routines may gain greater longevity benefits than those who focus on just one type of activity.

The findings are based on data drawn from two landmark long-term studies in the United States: the Nurses’ Health Study and the Health Professionals Follow-Up Study. Together, these studies included more than 173,000 participants, with over 111,000 individuals analysed in the current research. Participants were followed for more than 30 years, during which their physical activity habits were regularly assessed.

Researchers examined a broad spectrum of activities, ranging from aerobic exercises such as walking, jogging, cycling and swimming to lower-intensity practices like yoga and stretching, as well as resistance training, gardening and vigorous outdoor work. This comprehensive approach allowed scientists to assess not only how much people exercised, but also how diverse their physical activity patterns were.

Yang Hu, a research scientist at the Harvard T.H. Chan School of Public Health and the study’s corresponding author, said the team focused on physical activity because it is a modifiable factor that people can change to reduce the risk of early death. Unlike genetic factors, he explained, exercise habits can be adjusted at any stage of life, and decades of research have shown that many chronic diseases are largely preventable through healthy lifestyle choices.

At the end of the study period, higher total levels of physical activity were linked to a lower risk of death from all causes. Most individual activities showed protective effects, although the researchers noted that these benefits were not unlimited. The reduction in risk levelled off beyond a certain amount of exercise, suggesting that more is not always better.

Hu explained that this “ceiling effect” is common with healthy behaviours. While physical activity lowers risk, it cannot reduce it to zero. Importantly, the study found that combining different activities may be more effective than increasing the duration of a single one, as long as overall activity levels remain adequate.

One of the study’s most striking findings was the role of exercise variety. Participants who engaged in a greater range of physical activities had significantly lower mortality risks. Those with the highest diversity in activity types had a 19 per cent lower risk of death from all causes, along with a 13 to 14 per cent reduction in deaths related to heart disease, cancer, respiratory conditions and other illnesses.

According to Hu, this suggests that while maintaining sufficient overall activity remains the most important factor, mixing exercises that offer complementary benefits—such as endurance, strength and flexibility—may further reduce the risk of premature death.

Clinicians say the findings reinforce and refine existing advice. Dr Zeeshan Khan, chief of geriatrics at Hackensack Meridian Jersey Shore University Medical Center in New Jersey, described the results as both validating and encouraging. He noted that doctors have long urged patients to stay active, but the study adds an important new dimension by showing that variety matters just as much as volume.

Khan said the findings could help make exercise recommendations more flexible and patient-centred. For individuals who cannot run, alternatives such as swimming, chair-based exercises or strength training can still offer meaningful benefits. He hopes the research will encourage more collaborative discussions between doctors and patients about creating personalised, varied activity plans.

Sports medicine specialist Dr Bert Mandelbaum of Cedars-Sinai Orthopaedics echoed this view, comparing healthy ageing to training like a decathlete. To maintain what he calls “playspan”—the ability to remain physically active later in life—people need to engage their bodies in multiple ways. Balance, strength, resistance and both high- and low-impact activities all contribute to overall resilience and long-term health.

Looking ahead, experts say more research is needed, particularly studies that focus specifically on older adults. While participants in the current study were followed from middle age, Khan believes starting a varied exercise routine later in life would still be beneficial, though targeted research is required to confirm this. Future studies may also help define the ideal mix of activities and lead to evidence-based “longevity exercise prescriptions.”

For now, the message from researchers is clear: staying active remains essential, but mixing up workouts—rather than sticking to a single routine—may offer the greatest rewards for a longer, healthier life.