Abstract Body: Introduction: Different physical activities (PAs) may exert distinct physiological effects, yet associations of PA types and variety with mortality were unclear.

Methods: We prospectively followed 98,117 participants in the Nurses’ Health Study (1986-2018) and the Health Professionals Follow-up Study (1986-2020) who were free of chronic diseases at baseline. Leisure-time PA was assessed biennially with validated questionnaires and was expressed as MET-hr/week. PA variety was measured as the total number of PAs that participants consistently engaged in. Cox regression was used to examine the association between PA and mortality.

Results: During 2,180,153 person-years of follow-up, 32,665 deaths were recorded, with 8,314 from CVD, 8,932 from cancer, and 2,424 from respiratory disease [RD]. Total PA was inversely associated with mortality from any cause, CVD, cancer, RD, or other causes. Individual PAs, except for bicycling and swimming, were associated with lower mortality. The pooled multivariable-adjusted hazard ratios (95% CIs) of total mortality (highest vs. lowest group) were 0.85 (0.82, 0.88) for walking, 0.91 (0.87, 0.96) for jogging, 0.89 (0.82, 0.96) for running, 0.98 (0.95,1.01) for bicycling, 1.04 (1.00,1.09) for swimming, 0.86 (0.81, 0.91) for tennis, 0.90 (0.88, 0.93) for climbing stairs, 0.89 (0.86, 0.92) for rowing, and 0.90 (0.85, 0.95) for weight training. Non-linear relationships were found for total PA and most individual PAs: the risk reduction plateaued after reaching certain levels. Higher PA variety was significantly associated with lower mortality. After adjustment of total PA levels, participants in the highest quintile of PA variety score (vs. the lowest) had 15-32% lower mortality from any cause, CVD, cancer, RD, and other causes (all P-trend <0.001).

Conclusions: Most types of PA were associated with lower mortality. PA variety was inversely associated with mortality independent of total PA level. Our data suggest that long-term engagement of multiple types of PAs may benefit longevity.