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Physical Fitness, Biological Aging, and Healthy Longevity
Ziyuan Chen1, Paul James Collings1, Mengyao Wang1
1School of Public Health, The University of Hong Kong Li Ka Shing Faculty of Medicine, Pokfulam, Hong Kong.
Journal of the American Medical Directors Association
|August 11, 2025
Summary
Maintaining cardiorespiratory fitness (CRF) and muscle strength can offset risks from accelerated biological aging. Higher fitness levels mitigate premature health span termination, promoting longevity.
Area of Science:
- Gerontology
- Exercise Physiology
- Biomarkers of Aging
Background:
- Physical fitness, including cardiorespiratory fitness (CRF) and muscle strength, is linked to reduced disease risk and improved health outcomes.
- The combined impact of CRF and muscle strength on mitigating accelerated biological aging and promoting healthy longevity is not fully understood.
Purpose of the Study:
- To investigate if cardiorespiratory fitness (CRF) and muscle strength can modify the association between accelerated biological aging and premature termination of healthy longevity.
- To determine the role of physical fitness in the context of biological aging and its implications for health span.
Main Methods:
- A prospective observational study involving 46,481 participants from the UK Biobank.
- Cardiorespiratory fitness (CRF) assessed via bike protocols; muscle strength measured using hand dynamometers.
- Biological aging quantified by PhenoAge (based on 9 biomarkers and chronological age), with age acceleration (PhenoAgeAccel) calculated. Healthy longevity termination defined by 8 major health events or death.
Main Results:
- High CRF and muscle strength were individually associated with a significant reduction in health span termination risk (10% and 13%, respectively).
- Significant additive interactions were observed between PhenoAgeAccel and both CRF and muscle strength, with a multiplicative interaction with muscle strength.
- Accelerated biological aging posed the highest risk in individuals with low CRF and muscle strength, but this risk was partially offset by high fitness levels.
Conclusions:
- Enhanced cardiorespiratory fitness (CRF) and muscle strength can counteract the increased risk of premature health span termination linked to accelerated biological aging.
- Personalized fitness interventions should consider biological aging rates to optimize health span.
- Public health initiatives should focus on promoting cardiorespiratory and muscular fitness to combat age-related health risks.
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