A plain-English guide to the hallmarks of ageing, what they mean for your body, and which ones exercise can slow or partly reverse.
The hallmarks of ageing are a list of biological processes that researchers use to explain why cells, muscles and organs decline over time. The framework was published in 2013 with nine hallmarks and updated in 2023 to twelve. You cannot change all of them, but regular exercise acts on several, which is why it remains the most reliable tool we have for staying strong and independent for longer.
What the hallmarks of ageing are
Scientists grouped ageing into shared mechanisms so they could study why the same decline appears across different tissues and people. A hallmark has three features: it shows up during normal ageing, speeding it up shortens healthy life, and slowing it down can slow ageing in experiments. Most of the evidence comes from cells and animals, so be careful about assuming that a pill, diet or test can change them in people.
The 2023 list has twelve:
| Group | Hallmarks |
|---|---|
| Damage to cell machinery | Genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, disabled macroautophagy |
| Cell energy and response | Deregulated nutrient-sensing, mitochondrial dysfunction, cellular senescence |
| System-level changes | Stem cell exhaustion, altered intercellular communication, chronic inflammation, dysbiosis |
You do not need to memorise these. The practical point is that ageing is many slow processes at once, not one event.
Which hallmarks exercise influences
Human evidence is strongest for these links. Treat the rest as plausible rather than proven.
- Mitochondrial dysfunction. Regular aerobic training raises mitochondrial content and function in muscle, including in older adults. Steady work such as Zone 2 cardio is the usual approach, and our article on mitochondria and Zone 2 explains it.
- Chronic inflammation. People who exercise regularly tend to have lower resting markers such as C-reactive protein. The effect is modest and varies between studies.
- Deregulated nutrient-sensing. Muscle is the main place where blood glucose is used. Strength and aerobic training improve insulin sensitivity, which is why exercise lowers HbA1c in type 2 diabetes.
- Stem cell and tissue repair. Resistance training stimulates muscle satellite cells, which helps muscle adapt, even in people in their 70s and 80s.
- Cellular senescence. Animal studies suggest exercise lowers senescent cell burden. Human data are limited, so this remains an area of research.
Two practical results sit downstream of these hallmarks and are not on the list themselves: muscle loss and falling aerobic capacity. Strength training rebuilds muscle, and VO2 max training raises aerobic capacity, which strongly predicts survival. Balance, the other part of staying upright, is covered in balance and stability training.
What exercise cannot do
Exercise does not reset telomeres or reverse genomic damage in any proven way. No exercise programme has been shown to extend maximum human lifespan. What it does is lower the risk of early death, fall-related injury, cardiovascular disease and type 2 diabetes, and delay disability. Be wary of any marketing that claims an exercise, supplement or biological-age test “reverses” ageing. See our article on biological-age testing.
Why this matters in Malaysia
Malaysia is an ageing society, and the burden of diabetes, hypertension and heart disease is high. Many of these conditions share the processes above: inflammation, insulin resistance, and muscle loss. The same training that supports healthy ageing also treats these conditions. If you already have a diagnosis, see exercise for chronic conditions for how to start safely, and check with your doctor first if you have heart disease, uncontrolled blood pressure or insulin-treated diabetes.
What to do with this
The WHO recommends adults do 150 to 300 minutes of moderate aerobic activity a week and strength work on at least two days, with balance work added for older adults. Translated into a week:
- Two or three resistance sessions covering legs, hips, push, pull and trunk.
- Two to three aerobic sessions of 30 to 45 minutes at a conversational pace, plus one short hard session if your doctor agrees.
- Balance practice most days, such as a single-leg stand while brushing your teeth.
- Movement spread through the day, since long sitting is a separate risk.
To see how you are doing, track simple measures from longevity metrics and testing.
How hard do you need to train?
For muscle, the NSCA position statement on older adults supports moderate to heavy loads, for example working up to 3 sets of 8 to 12 repetitions on multi-joint exercises, two to three days a week, increasing load gradually. Beginners start lighter and focus on technique. For aerobic fitness, 150 to 300 minutes of moderate activity a week is the WHO range, and most of that should be at a comfortable pace.
You do not need extreme volumes. Trials showing improved muscle function in people in their 70s, 80s and 90s used ordinary gym-based programmes, supervised, over weeks to months. Consistency over years matters more than any one session.
What about supplements and “anti-ageing” products?
Many products are marketed as acting on a hallmark, for example NAD+ boosters for mitochondria, or senolytics for senescent cells. Most of this evidence is from cells or animals, and human trials are few, small or short. Exercise is the one intervention with consistent human evidence for improved function and lower mortality. Read is exercise better than longevity supplements and supplements for longevity in Malaysia before spending money, and talk to your doctor if you take regular medication.
Who should be careful
Check with your doctor before starting or increasing exercise if you have known heart disease, chest pain, breathlessness out of proportion to effort, uncontrolled blood pressure, insulin-treated diabetes, or recent surgery. Stop and seek care for chest pain, fainting, new severe joint pain or irregular palpitations. Older adults who have fallen or feel unsteady should start with supported balance work and low loads. See when to get medical clearance before exercise.
Key takeaways
- The hallmarks of ageing are twelve biological processes described in 2013 and expanded in 2023, mostly studied in cells and animals.
- Exercise acts on several of them in humans, notably mitochondrial function, insulin sensitivity, inflammation and muscle repair.
- It lowers the risk of early death and disability, but no exercise has been shown to stop or reverse ageing.
- Muscle loss and falling aerobic capacity are the changes that most affect independence, and both respond to training.
- Be sceptical of products claiming to reverse hallmarks.
If you want a programme matched to where your body is now, our coaching services start with a baseline assessment.