Cardiorespiratory fitness and all-cause mortality: no upper limit found
In 122,007 adults who did a treadmill test, higher fitness meant lower long-term mortality, and the fittest had the lowest risk of all.
What they studied
- Design
- Retrospective cohort
- People
- 122,007 adults referred for treadmill testing, mean age 53
- Follow-up
- Median 8.4 years, 13,637 deaths
- Measure
- Peak METs, grouped from low (<25th percentile) to elite (≥97.7th)
What they found
- Mortality fell step by step with every fitness group, with no point where more fitness stopped helping.
- The least fit group had about 5× the risk of death of the elite group (adjusted HR 5.04).
- Low fitness carried as much or more risk than smoking (HR 1.41), diabetes (1.40) or coronary artery disease (1.29).
- Elite fitness still beat high fitness in people aged 70+ and in people with high blood pressure.
How strong is the evidence
Cohort · n≈122k
What this design cannot tell us:
- Observational: it shows an association, not that training caused the lower risk.
- Patients referred for a test, not a random sample of the population.
- Fitness was measured once and estimated from treadmill time.
What it means for your training
- Treat VO₂max as a vital sign: test it, then train it.
- The biggest drop in risk comes from leaving the lowest group, so start there.
- Keep pushing: in this data there was no ceiling on the benefit.
Our summary of the published abstract. Read the original paper for full details.
More on longevity
30–60 minutes of strength work per week, lower mortality risk
Momma et al. · Br J Sports Med · 2022
The first four weeks predict who is still training a year later
Conti et al. · Front Sports Act Living · 2026
Nightly HRV swings mirror your habits
Grosicki et al. · Am J Physiol Heart Circ Physiol · 2026