BACKGROUND/OBJECTIVES: With the accelerating global population aging, delaying aging and promoting healthy aging have become focal points in public health and clinical medicine. Phenotypic age acceleration (PhenoAgeAccel) is an important indicator of biological aging speed. This study aims to explore the relationship between different leisure-time physical activity (LTPA) patterns and PhenoAgeAccel, analyzing the association and dose-response relationship.

METHODS

This study utilized data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018, including 14,868 adults. Multivariable linear regression models and restricted cubic spline methods were used to assess the relationship between LTPA and PhenoAgeAccel, with segmented likelihood ratio tests to detect non-linear thresholds. Stratified regression and interaction tests explored potential modifications by sex, age, race, and socioeconomic status.

RESULTS

Compared to individuals with no LTPA, those with inactive and regular LTPA patterns had significantly lower PhenoAgeAccel scores ( < 0.05), while the weekend warrior pattern showed no significant effect ( > 0.05). A non-linear threshold effect was found; below 560 min of weekly LTPA, a significant negative correlation existed (β = -0.001, 95 % CI: 0.001 to -0.0003,  < 0.001). Above this threshold, LTPA was positively correlated with PhenoAgeAccel, indicating a risk for accelerated aging (β = 0.0003, 95 % CI: 0.00002 to 0.001,  = 0.03). Similar non-linear threshold effects were found for both males and females.

CONCLUSION

Regular LTPA significantly reduces phenotypic age acceleration, with a non-linear threshold effect indicating moderate physical activity is most beneficial. The weekend warrior pattern was less effective. These findings highlight the necessity of personalized physical activity recommendations and provide evidence for public health strategies to promote healthy aging.