Exercise stands alone in the evidence for a longer healthspan

Living longer is only half the goal; the years need to be worth living. Healthspan, the period of life spent in good health, has become a public health priority, and researchers increasingly measure it through person-centred outcomes such as intrinsic capacity and quality of life, which capture how well someone functions rather than which diseases they carry. Plenty of interventions claim to extend healthspan, from exercise to supplements to calorie restriction, but claims and randomised evidence are different things. This review asked which interventions actually have trial evidence for improving these functional, multidimensional outcomes in humans.

The review was registered in advance and conducted following PRISMA guidelines. The authors systematically searched MEDLINE, EMBASE and grey literature for randomised controlled trials evaluating interventions that improve intrinsic capacity or quality of life, including articles published up to October 16, 2025. From 1960 publications identified, 15 articles met the inclusion criteria, covering 4656 participants. The included interventions varied considerably: 7 studies tested exercise alone, 6 tested multidomain programmes that all contained an exercise component, 2 tested daily oral supplementation and 1 tested caloric restriction.

Overall, 11 of the 15 studies reported that exercise, or a multidimensional intervention built around an exercise component, improved intrinsic capacity and quality of life. The benefit did not appear tied to one style of training: aerobic exercise alone, resistance training alone, or combinations of different exercise types all featured in the positive evidence. For the remaining approaches, daily supplementation and caloric restriction, the number of studies was too small and the interventions too varied for any conclusion to be drawn either way. The authors are explicit that this is an absence of evidence rather than evidence of absence.

Exercise already has a deep evidence base for individual outcomes such as strength, cardiovascular fitness and mood; this review extends that to the newer, broader framing of healthspan measured through functioning and quality of life. It also exposes how thin the trial evidence remains for the other interventions that dominate longevity conversations, including supplements and calorie restriction. The small number of eligible trials and their wide variation limit what can be said with confidence, and the authors call for research across more diverse populations before firmer conclusions are possible.

For a reader weighing where to invest effort in ageing well, this is a reason to see exercise as the intervention with the receipts, at least for the functional outcomes that determine how life actually feels in later years. It is also a useful corrective to longevity marketing: the trial evidence for supplements and calorie restriction improving these person-centred outcomes is currently too sparse to judge, which is not the same as saying they fail. The choice of exercise type appears flexible, since aerobic, resistance and combined approaches all appear in the supportive studies.