Which Sports Help You Live the Longest?
Key findings: 60-second read
- Not all sports are equal for longevity - tennis players gained 9.7 years of life expectancy compared to sedentary individuals, while health club activities added only 1.5 years.
- Social sports topped the list - tennis (9.7 years), badminton (6.2 years), and soccer (4.7 years) all outperformed solitary activities like jogging (3.2 years) and swimming (3.4 years).
- More exercise time did not mean more benefit - health club participants spent the most time exercising (599 minutes/week) but had the smallest longevity gain.
- Cycling was the most popular activity - 56% of active participants cycled, spending an average of 386 minutes per week, with a life expectancy gain of 3.7 years.
- Social connection may be the hidden factor - sports requiring interaction with others were associated with the greatest longevity benefits, consistent with research showing social support strongly predicts survival.
We all know that physical activity is good for us. But does it matter what activity we choose? According to a landmark study from the Copenhagen City Heart Study, the answer appears to be yes, and the differences are striking.
Published in Mayo Clinic Proceedings in 2018, this prospective cohort study followed 8,577 healthy men and women for up to 25 years, examining how different leisure-time sports were associated with life expectancy. The findings challenge the simple notion that any exercise is equally beneficial and point to an often-overlooked factor: social interaction.
This article breaks down the study's methods, key findings, and clinical implications for physiotherapists and anyone looking to optimise their physical activity for longevity.
"Various sports are associated with markedly different improvements in life expectancy. Interestingly, the leisure-time sports that inherently involve more social interaction were associated with the best longevity."
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Study design and population
The Copenhagen City Heart Study (CCHS) is a prospective population study initiated in 1976, comprising a random sample of 19,329 men and women aged 20-93 years from the Copenhagen Population Register. This analysis used data from the third examination (1991-1994) and followed participants for all-cause mortality until March 22, 2017.
After excluding individuals with a history of coronary heart disease, stroke, cancer, or missing physical activity data, the final analytic sample included 8,577 healthy participants (mean age 61 years for sedentary participants; younger for active participants).
Sample size: 8,577 participants
Follow-up duration: Up to 25 years
Deaths recorded: 4,448
Sedentary participants: 1,042 (12%)
Active participants: 5,674 (66%) engaged in at least one sport
Participants completed detailed questionnaires about their participation in eight specific sports: tennis, badminton, soccer, jogging, cycling, calisthenics (low-intensity gymnastics), swimming, and health club activities (treadmill, elliptical, weights). The study adjusted for multiple confounding variables including age, sex, total physical activity volume, smoking, education, income, alcohol intake, and diabetes mellitus.
Life expectancy gains by sport
The multivariable-adjusted life expectancy gains compared to sedentary individuals were as follows:
| Sport | Life expectancy gain (years) | Hazard ratio (95% CI) |
|---|---|---|
| Tennis | 9.7 years | 0.36 (0.22-0.59) |
| Badminton | 6.2 years | 0.53 (0.41-0.69) |
| Soccer | 4.7 years | 0.61 (0.41-0.90) |
| Cycling | 3.7 years | 0.69 (0.62-0.77) |
| Swimming | 3.4 years | 0.71 (0.62-0.82) |
| Jogging | 3.2 years | 0.72 (0.55-0.94) |
| Calisthenics | 3.1 years | 0.73 (0.65-0.82) |
| Health club activities | 1.5 years | 0.86 (0.63-1.17) |
Several patterns emerge from these data. First, all forms of physical activity were associated with improved life expectancy compared to being sedentary. Even health club activities, which had the smallest gain, added 1.5 years. However, the range of benefit is remarkably wide - from 1.5 to 9.7 additional years.
Second, the sports with the greatest longevity benefits share a common feature: they are inherently social. Tennis, badminton, and soccer all require at least one other person to play. The solitary activities - jogging, swimming, cycling, and health club activities - clustered at the lower end of the benefit spectrum.
"Interestingly, sports that require 2 or more individuals to play together and socially interact - tennis, badminton, and soccer - were the sports that were associated with the best improvements in longevity, whereas the less inherently interactive forms of PA, such as jogging, swimming, cycling, and health club activities, were associated with less impressive longevity benefits."
Duration vs benefit: a surprising finding
One might assume that spending more time exercising would lead to greater longevity benefits. The data do not support this assumption.
Health club participants spent the most time exercising (599 minutes per week, nearly 10 hours) but had the smallest life expectancy gain (1.5 years). In contrast, tennis players spent far less time (approximately 100 minutes per week on their primary sport) but gained 9.7 years.
Cyclists spent an average of 386 minutes per week cycling (the highest of any single sport), and 73% of cyclists spent more than 4 hours per week riding. Yet cycling was associated with a 3.7-year gain - less than half that of tennis.
This suggests that the quality and nature of physical activity may matter more than the quantity, at least when it comes to longevity.
The social factor: why interaction matters
The study authors propose that social interaction may be a key explanatory variable. They cite previous research showing that social support has a stronger effect on long-term survival than any other factor, including being a non-smoker, staying lean, or having normal blood pressure.
A widely cited meta-analysis found that having good interpersonal connections conferred twice as much protection against early mortality compared to being physically active. Other research shows that increasing the number of in-person friendships increases one's sense of well-being.
The authors write: "If social support and interpersonal relationships exert stronger effects on life expectancy than does exercise, then the highly social but less physically demanding sports such as doubles tennis, badminton, and golf conceivably could be more strongly associated with longevity than more solitary but arduous activities such as running, cycling, stationary exercise machines, and swimming."
An alternative explanation is that sports like tennis and badminton involve interval bursts of exercise using large muscle groups and full body movements, whereas continuous moderate-intensity activities may confer different physiological benefits. A growing body of evidence indicates that short, repeated intervals of higher intensity exercise appear superior to continuous moderate-intensity activity for improving health outcomes.
Key insight on social connection: A scientifically rigorous and widely cited meta-analysis found that social support had a stronger effect on long-term survival than any other factor, including being a non-smoker, staying lean, or having normal blood pressure. Having good interpersonal connections conferred twice as much protection against early mortality compared with being physically active.
Comparison with other research
The study authors note that only one other major study has analysed the associations of various types of exercise with all-cause mortality: a UK study of 80,306 men and women from the Health Survey for England and the Scottish Health Survey.
That UK study similarly found that the most robust reduction in all-cause mortality was noted for participation in racquet sports (hazard ratio, 0.53; 95% CI, 0.40-0.69), with considerable reductions also noted for swimming (HR, 0.72) and aerobics (HR, 0.73). In contrast to the Copenhagen study, the UK study reported less impressive associations for soccer (HR, 0.82) and running (HR, 0.87), though these did not reach statistical significance.
The consistency of the finding for racquet sports across two large, independent cohorts is noteworthy and suggests a genuine association rather than a chance finding.
Strengths and limitations
Strengths of the study include:
- Prospective design with 25 years of follow-up
- Large, random sample representative of the Copenhagen population
- 100% follow-up (no participants lost to follow-up)
- Detailed information on potential confounding variables
- Adjustment for total physical activity volume, isolating the effect of sport type
Limitations to consider:
- Observational design - cannot establish causation; residual confounding may explain some associations
- Participants engaged in multiple sports - the ideal would have been participants in only one sport, but most active individuals engaged in several activities
- Self-reported physical activity - subject to recall bias
- Baseline differences - participants in different sports had different characteristics (tennis players, for example, were more likely to have a university degree and better self-rated health)
- Health club activities not differentiated - the study could not separate time spent on aerobic vs anaerobic exercise within health clubs
The authors attempted to address confounding by education by restricting analysis to individuals with a university degree. In this subgroup, tennis players still had the lowest risk of mortality (HR, 0.26; 95% CI, 0.10-0.69), suggesting that socioeconomic factors alone do not explain the findings.
"Because this is an observational study, it remains uncertain whether this relationship is causal or merely an association. Interestingly, sports with more social interaction appeared to be associated with the greatest longevity; therefore, the impact of social interaction during LTPA appears to warrant additional study."
Clinical implications for physiotherapists and health professionals
This study has several important implications for clinical practice and patient recommendations:
1. Consider social context when recommending physical activity. For patients who are able to participate in group or partner sports, the longevity benefits may be substantially greater than solitary activities. This does not mean solitary exercise is without value - all forms of physical activity were beneficial compared to being sedentary - but the magnitude of benefit differs.
2. Duration is not the only variable. Patients who spend hours on exercise machines may be disappointed to learn that their longevity benefit may be less than those playing tennis for a fraction of the time. This may help reframe expectations and encourage more enjoyable, social forms of activity.
3. The importance of adherence. The best exercise is the one a patient will actually do consistently. For some patients, solitary activities like jogging or swimming may be more accessible or enjoyable than team sports. The study should not discourage these activities; rather, it suggests that adding a social component where possible may enhance benefits.
4. Social prescribing. For patients with chronic conditions, recommending participation in social physical activities (walking groups, community sports, fitness classes) may address both physical and psychosocial health simultaneously.
5. Individualisation remains key. Not every patient can play tennis or soccer due to physical limitations, injuries, or access. The study's findings should be applied thoughtfully, considering each patient's unique circumstances.
Conclusion
The Copenhagen City Heart Study provides compelling evidence that different sports are associated with markedly different improvements in life expectancy. Tennis led the way with a 9.7-year gain, followed by badminton (6.2 years) and soccer (4.7 years). Solitary activities like jogging, swimming, and cycling produced more modest gains of 3-4 years, while health club activities added only 1.5 years.
The study's most intriguing finding is the possible role of social interaction. Sports that inherently involve playing with others consistently outperformed solitary activities, even when the solitary activities involved more time and exertion. This aligns with a large body of research showing that social connection is one of the strongest predictors of longevity.
As the authors note, because this is an observational study, it remains uncertain whether these relationships are causal. However, the consistency of findings across different populations and the plausible biological mechanisms (reduced stress, improved mental health, accountability, social support) suggest that the social aspects of physical activity deserve serious consideration in public health recommendations and clinical practice.
One key insight from this study
"Tennis players lived 9.7 years longer than sedentary individuals, while health club participants gained only 1.5 years despite spending the most time exercising (599 minutes/week). Sports requiring social interaction - tennis, badminton, soccer - consistently outperformed solitary activities, suggesting that who you exercise with may matter as much as how you exercise."
Frequently asked questions
Does this mean I should stop jogging and join a tennis club?
Not necessarily. The study shows associations, not causation. Jogging was still associated with a 3.2-year life expectancy gain compared to being sedentary, which is substantial. If you enjoy jogging and it keeps you active, that is valuable. However, if you are open to adding a social component to your exercise routine, this study suggests you might derive additional benefits. Consider joining a running group rather than running alone, or adding one social sport per week.
Could the results be explained by wealth or education rather than the sports themselves?
The study authors attempted to address this by adjusting for education, income, and other socioeconomic factors in their statistical models. The differences in life expectancy persisted after these adjustments. Furthermore, when they restricted the analysis to only individuals with a university degree, tennis players still had the lowest risk of mortality (HR, 0.26). However, residual confounding cannot be completely ruled out, and the authors acknowledge this limitation.
What about other sports not studied, like golf, basketball, or dancing?
The study did not examine all possible sports. However, the authors note that other research has found golf to be associated with a 5-year life expectancy gain. Based on the pattern observed, sports that combine physical activity with social interaction would be hypothesised to show benefits similar to tennis and badminton. Dancing, for example, involves both physical exertion and social connection and would be a reasonable candidate for similar benefits, though not directly studied here.
How much tennis or badminton do I need to play to get these benefits?
The study did not provide detailed dose-response data for each sport. However, the average tennis player in the study spent approximately 100 minutes per week on tennis. This suggests that relatively modest amounts of social sport participation may be sufficient to derive benefits. The key appears to be regular, consistent participation rather than extreme volumes of exercise.
Does this apply to older adults or people with physical limitations?
The study included participants up to age 98, with a mean age of 61 in the sedentary group and younger in the active groups. However, older adults or those with physical limitations may not be able to participate in high-intensity racquet sports. The principle - finding social forms of physical activity that are enjoyable and sustainable - can still apply. Walking groups, chair-based exercise classes, or modified racquet sports (doubles tennis, pickleball) may offer similar social benefits with lower physical demands.
As a physiotherapist, I often help patients find physical activities that they will actually enjoy and stick with long term. This study reinforces something I have observed clinically: the patients who stay active for years are often those who have found a social component to their exercise - a walking group, a tennis partner, a local soccer team.
Physical activity is medicine, but like any medicine, adherence matters. If social sports keep you coming back week after week, the longevity benefit may come not just from the exercise itself but from the relationships, accountability, and joy that come with playing with others.
If you are looking to start or change your physical activity routine, consider what will be sustainable for you. And if you have the opportunity to add a social element - joining a club, finding a partner, or participating in group classes - this study suggests it may be well worth the effort.
If you are dealing with pain or injury that limits your ability to participate in sports, I can help. I see patients in Port Macquarie and via telehealth to develop individualised activity plans that work with your body's limitations while still providing meaningful health benefits.
- Grant
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Disclaimer: This information is for educational purposes and does not replace individualised medical or exercise advice. Always consult a qualified health professional before starting a new physical activity program. This blog post summarises a published research study (Schnohr P, O'Keefe JH, Holtermann A, et al. Various leisure-time physical activities associated with widely divergent life expectancies: the Copenhagen City Heart Study. Mayo Clin Proc. 2018); the original source should be consulted for full methodological details. Individual responses to physical activity may vary.
