The review, led by Pierre Philippe Wilson Registe of the Université de Sherbrooke and colleagues in Canada, is the first comprehensive update in nearly two decades. The last major systematic review on this topic, published by Hallal and colleagues in 2006, covered articles from 2000 to 2004 and documented weak to moderate associations between adolescent physical activity and adult physical activity, breast cancer risk, bone health, and cardiovascular risk factors. It did not touch mental health, quality of life, or general health at all. Since then, a surge of cohort studies has generated new knowledge about how teenage exercise relates to future well-being, and the new review pulls that scattered evidence into a single, coherent picture.

To do so, the team searched five major databases — AMED, Medline, CINAHL, APA PsycINFO, and Embase — using keywords representing five concepts: physical activity, adolescence, health status, early adulthood, and longitudinal design. They considered only articles in English or French, included participants aged 12 to 29 years, and required studies to measure the association between physical activity during adolescence and health markers in early adulthood. Of 5,188 articles identified, 44 met the inclusion criteria. The studies were conducted in the Americas (23), Europe (17), and Oceania (4), with publication years spanning 2002 to 2024. None were judged to be of low quality; 25 were rated moderate and 19 good on the McMaster University critical appraisal tool.

The review’s most striking finding concerns the persistence of exercise behavior itself. Sixteen of the 18 studies that assessed whether physical activity levels or participation track from adolescence into early adulthood supported a positive association — though the strength was low to moderate, with correlations below 0.3. In practical terms, an active teenager is more likely to be an active young adult, but the relationship is far from deterministic. Seven of the 18 articles reported mixed positive-null findings, meaning the association held for some measures but not others. Notably, two Finnish studies found that active transportation in adolescence — walking or cycling to school — was unrelated to device-measured physical activity levels in early adulthood, making it the only type of teenage exercise that showed no long-term link to adult activity levels.

Physical health outcomes told a similarly nuanced story. Of 17 studies examining physical health, 11 found a positive relationship and 6 found no association. Bone health emerged as a particularly robust benefit: four studies found that physically active adolescents had better bone mineral density, bone size, content, and strength in early adulthood, particularly at the hip and proximal femur. One UK study found that moderate-to-vigorous physical activity during adolescence, but not light-intensity activity, was positively associated with hip bone mineral density measured by dual-energy x-ray absorptiometry at age 25 for both sexes. Body mass index was the most studied cardiovascular risk factor, and six studies supported that active adolescents have lower BMI in early adulthood compared to inactive peers. Interestingly, all four studies that examined blood pressure found no association — a null result the authors attribute to the strong cardiovascular homeostatic mechanisms of young adults, whose blood pressure levels were within normal ranges with little variance, making any exercise effect difficult to detect.

Mental health may be where the review carries its greatest public health weight. Of 18 studies using mental health outcomes, 16 suggested that physical activity in adolescence is beneficial to mental health in early adulthood. Eleven articles studied depression or depressive symptoms, and ten of them showed adolescent physical activity was protective. Team sport involvement appeared protective in one study while individual sport involvement did not, and two studies found the association only for boys, not girls. Anxiety was measured in six articles, with team sport participation emerging as a protective factor in two of four studies focused on that domain. Four articles examined stress, with two finding that school sports participation or high physical activity levels in adolescence were related to lower stress in early adulthood. Two further studies showed that longer team sports participation and higher physical activity levels during adolescence were associated with better positive mental health in young adults.

The authors propose the behavioral tracking hypothesis as a primary explanation for these long-term effects. Active adolescents are more likely to remain active later in life and to develop healthier behaviors, which supports health benefits throughout life. The review supports this by showing that sports participation and physical activity levels in adolescence track to a low-to-moderate extent into early adulthood, suggesting that part of the exercise habits acquired in adolescence persist through the transition to adulthood. It is possible that physical activity tracked from adolescence to early adulthood because of habit formation and because exercise is socially patterned — the social interactions and networks developed through physical activity during adolescence may continue to influence behaviors in future years. For mental health specifically, the effect of adolescent physical activity on young adult well-being seemed to be mediated by factors such as self-esteem, self-efficacy, and emotional and social skills developed through exercise.

Quality of life and general health rounded out the picture. Only three studies examined adolescent physical activity and quality of life in early adulthood, with two reporting positive associations — one 8-year study found that fulfilling the WHO physical activity recommendation was positively associated with health-related quality of life, and a 13-year study found that later adolescence physical activity was a strong predictor of future quality of life. In contrast, a study with a longer follow-up found no association. General health was more consistent: in all five studies that assessed this relationship, more physical activity in adolescence was associated with better general health in early adulthood, regardless of whether the exposure was measured as sports participation, physical activity level, or specific activities.

The review is not without limitations. A meta-analysis was not feasible due to substantial heterogeneity among the included studies — variations in definitions of physical activity during adolescence, developmental periods assessed, and measurement approaches for the same outcomes in young adulthood. As an alternative, the team used a vote counting approach based on the direction of effect within each study, classifying associations as positive, negative, null, or mixed. Several studies adjusted for potential confounders, but residual confounding remains a concern: socioeconomic status, parental education, family environment, and co-occurring health behaviors such as diet, smoking, and alcohol use are closely linked to both physical activity participation during adolescence and health outcomes in adulthood, and inconsistent adjustment for these factors may partly explain the generally small observed associations. The majority of studies also relied on self-report measures, which are prone to recall and social desirability bias, and none used compositional data analysis to capture the composite nature of physical activity, a recommendation of the 2030 Global Action Plan. Generalizability may be limited as well, since most studies were conducted in the United States, Europe, and Oceania, and the review was restricted to English and French publications.

Still, the overall message is clear and consistent. With the exception of active transportation, participating in most types of physical activity during adolescence appears to confer small but beneficial effects across health outcomes in the future — higher physical activity levels, fewer mental health issues, better bone mineral density, lower BMI, fewer cardiovascular risk factors, and better general health. The associations were generally in the same direction among boys and girls, suggesting the relationships are broadly consistent across sexes. The authors conclude that the results support the potential importance of promoting physical activity throughout adolescence for health in early adulthood. In an era when teenage exercise is dropping for most individuals during the transition to adulthood, the evidence suggests that the investment made in those formative years may pay dividends well beyond the teenage decade itself.

Subject of Research: Health

Article Title: Long-term associations between physical activity during adolescence and health in early adulthood: a systematic review

Article References: Registe, P. P. W., Black, S., Gallant, F., Tanguay, P., Saucier, D., Faivre, P., Mekari, S., & Bélanger, M. (2026). Long-term associations between physical activity during adolescence and health in early adulthood: a systematic review. Frontiers in Adolescent Medicine, 4, Article 1808570. https://doi.org/10.3389/fradm.2026.1808570

Image Credits: AI Generated

DOI: 10.3389/fradm.2026.1808570

Keywords: physical activity, adolescence, mental health, systematic review, public health, bone health, longitudinal studies, Long-term, associations, between, physical, activity