Optimal Exercise Combination: 60–119 Minutes of Strength Training Plus High Aerobic Activity Linked to 45–58% Lower Mortality Risk
核心洞察
A 30-year analysis of over 147,000 participants found 90–119 minutes of weekly strength training was associated with a 13% lower all-cause mortality risk, with no additional benefit beyond 120 minutes.
Combining high aerobic activity (30–44 MET hours/week) with 60–119 minutes of strength training yielded a 45% lower mortality risk; at 45+ MET hours, risk reduction reached 53–58%.
Strength training alone was linked to a 19% lower cardiovascular death risk and a 27% lower neurological disease (搜索) death risk, though researchers urge caution interpreting neurological findings.
A large-scale analysis spanning three decades and more than 147,000 participants has identified a "sweet spot" for combining aerobic and strength training to maximize longevity. The study, published in the British Journal of Sports Medicine, found that 90 to 119 minutes of weekly resistance training was associated with a 13% lower risk of death from any cause, while combining high levels of aerobic activity with 60 to 119 minutes of strength training reduced mortality risk by as much as 45% to 58%.
Researchers from the Harvard T.H. Chan School of Public Health analyzed data from three major prospective cohort studies: the Health Professionals Follow-up Study (1992–2022), the Nurses' Health Study (2002–2021), and the Nurses' Health Study II (2003–2021). Together, these studies included 147,374 participants — 31,540 men and 115,834 women — with an average age of 54 at baseline. Every two years for up to 30 years, participants reported their weekly aerobic exercise and strength training regimens.
"The benefits of aerobic activity for longevity are already well established," said Edward Giovannucci, MD, ScD, professor of nutrition and epidemiology at the Harvard T.H. Chan School of Public Health and corresponding author of the study. "What has been less clear is how resistance training relates to long-term mortality risk, especially at different volumes and in combination with aerobic activity."
Dose-response findings for strength training
Over the 30-year follow-up period, 35,798 participants died. After accounting for confounding factors, researchers observed that participants who performed 90–119 minutes of strength training per week had a 13% lower risk of all-cause mortality. Notably, no additional reduction in risk was observed above 120 minutes per week.
That same 90–119 minute range was also associated with a 19% lower risk of death from cardiovascular disease (搜索) and a 27% lower risk of death from neurological disease (搜索).
"For cardiovascular disease (搜索) mortality, this finding is generally consistent with previous studies showing that resistance training is associated with lower cardiovascular disease risk, particularly for myocardial infarction (搜索)," Giovannucci explained. Regarding neurological disease (搜索) mortality, he noted growing evidence suggesting strength training may help preserve cognitive function, but added a caution: "Neurodegenerative diseases such as Alzheimer's (搜索) can begin many years before diagnosis, and early symptoms may reduce a person's ability or motivation to exercise. Also, neurological causes of death, especially dementia, can be difficult to classify accurately. More research is needed before drawing firm conclusions."
Cancer (搜索)-related benefits appeared at lower amounts of strength training. Participants who performed 1–29 minutes per week had a 21% lower risk of cancer death, while those doing 30–59 minutes per week had an 18% lower risk.
The combined effect of cardio and resistance training
Approximately three-quarters (74%) of participants exceeded the recommended 150 minutes of moderate-intensity aerobic exercise per week, equivalent to 7.5 MET hours. Nearly half (46%) reported doing some form of strength training.
Compared with individuals who did less than 7.5 MET hours of aerobic activity per week and no strength training, those who performed strength training alone for 1–59 minutes or 60–119 minutes per week had a 7–11% lower risk of death. Aerobic exercise on its own showed strong benefits: any amount above 7.5 MET hours per week was associated with a 26–43% lower risk of death.
The lowest mortality risk was observed among participants who combined both modalities. Those who accumulated 30–44 MET hours of aerobic activity per week and 60–119 minutes of strength training had a 45% lower risk of death. Even greater reductions were seen among participants who performed 45 or more MET hours of aerobic activity per week — in that group, the risk of death was 53% to 58% lower, regardless of how much strength training they did.
"Aerobic exercise is generally linked to improved hemodynamics, lipid profiles, and cardio-respiratory fitness, whereas resistance training may improve glucose metabolism, body composition, and muscular strength," said Yiwen Zhang, PhD, postdoctoral research fellow at the Harvard T.H. Chan School of Public Health and first author of the study. "Some randomized trials in patients with coronary artery disease (搜索) also found that, compared with aerobic activity alone, combining aerobic and resistance training yields greater improvements in cardiorespiratory fitness and body composition."
Clinical perspective and implications
Swapnil Patel, MD, MHCM, FACP, vice chair of the Department of Medicine at Hackensack Meridian Jersey Shore University Medical Center, who was not involved in the study, commented that the findings reinforce a long-standing preventive medicine message: "Exercise should not be viewed as an 'either-or' choice between cardio and strength training."
"Many patients focus heavily on walking, running, cycling, or other aerobic activities because they are often associated with heart health and weight loss," Patel said. "This study provides compelling long-term evidence that resistance training offers independent benefits and appears to further reduce mortality risk when combined with aerobic exercise."
Patel also highlighted the neurological findings as particularly noteworthy: "As our population ages and conditions such as dementia and neurodegenerative diseases become increasingly prevalent, identifying lifestyle interventions that may help preserve neurological health is a major public health priority."
David Cutler, MD, a board-certified family medicine physician at Providence Saint John's Health Center in Santa Monica, CA, emphasized the importance of a comprehensive approach: "A lot of people just focus on one form of exercise... This program, nor others, have focused on how important a comprehensive exercise program is, which incorporates strength training, aerobics, core, and stretching."
Study limitations
The researchers emphasized that this was an observational study and cannot prove causation. Exercise habits were self-reported, which can introduce inaccuracies. The analysis did not include certain forms of strength training such as calisthenics and Pilates, and information was not available on the duration of individual workouts or the intensity of strength training sessions.
Giovannucci indicated that future research will examine resistance training in more diverse populations and in relation to outcomes beyond mortality, such as physical function, independence, and quality of life. "It will also be important to study resistance training more precisely, including exercise type, intensity, load, and using more objective measures if possible," he added.