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Frontiers in Adolescent Medicine ·

Volume 4 - 2026 | https://doi.org/10.3389/fradm.2026.1808570

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

  • Pierre Philippe Wilson Registe1,2
  • Sophie Black3
  • François Gallant4,5
  • Pamela Tanguay1,2
  • Daniel Saucier1,2
  • Pierre Faivre1,2
  • Saïd Mekari1,2
  • Mathieu Bélanger1,2,5*corresponding author
  1. 1Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC, Canada
  2. 2IMPACTS Lab, Centre de Formation Médicale du Nouveau Brunswick, Université de Sherbrooke, Moncton, NB, Canada
  3. 3Faculté des sciences de la santé et des services communautaires, Université de Moncton, Moncton, NB, Canada
  4. 4Department of Family Medicine, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
  5. 5Vitalité Health Network, Moncton, NB, Canada
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Abstract

Despite the recent surge in cohort studies examining the long-term effects of physical activity (PA) during adolescence on health in adulthood, no recent literature review summarizes this relationship. We systematically reviewed the literature on the associations between PA in adolescence and health markers in early adulthood, including PA, physical health, mental health, quality of life, and general health. We searched the AMED, Medline, CINAHL, APA PsycINFO and Embase databases with a combination of keywords representing five concepts: PA, adolescence, health status, early adulthood, and longitudinal. We considered only articles in English or French, included participants aged 12–29 years, and measured the association between adolescent PA and young adults' health. Of the 5,188 articles identified, we retained 44. Sixteen of the 18 studies that assessed the association between PA levels or participation over time, from adolescence to early adulthood, supported a low-to-moderate positive association. In 17 studies examining physical health as an outcome, 11 found a positive relationship, and 6 found no association. The results of 16 out of 18 studies using mental health outcomes suggest that PA in adolescence is beneficial to mental health in early adulthood. Only three studies have examined adolescent PA and quality of life in early adulthood, with two reporting positive associations. In all five studies that assessed this relationship, more PA in adolescence was associated with better general health in early adulthood. This review highlights that PA during adolescence is associated with improved health outcomes in early adulthood.

Keywords

1 Introduction

The beneficial effects of physical activity (PA) on health are well-documented across the lifespan (1). From a life-course, health in adulthood is shaped by exposures and behaviors experienced earlier in life, with adolescence representing a critical developmental period during which PA may influence long-term health trajectories (2, 3). Regular PA has well-established short-term benefits for multiple aspects of health, including brain development (4, 5), bone health (6), cognition (4, 5), mental health (7–9), physical fitness (10), the prevention of non-communicable diseases (11, 12) and reduced risks of falls (13). These benefits are observed during childhood, adolescence, adulthood, and older adulthood (1, 6), and form the basis of national and international guidelines that primarily emphasize age-specific, short-term health outcomes (1, 14). However, recent studies suggest that the benefits of PA during childhood and adolescence may extend into adulthood (15–17). This emerging evidence reinforces the life-course perspective by highlighting adolescence as a potentially important window during which PA may shape future health outcomes.

Several studies suggest that adolescent PA represents one of the behaviors that best predict adults' health outcomes (6, 18, 19). However, the long-term effect of adolescent PA on young adults' health remains poorly understood. The latest literature review to summarize evidence on this subject dates from 2006 (6). This review by Hallal et al. analyzed articles published between 2000 and 2004 and documented weak to moderate associations between PA in adolescence and PA in adulthood, as well as between adolescent PA and the risk of developing breast cancer, bone fractures, poor bone health indicators, and cardiovascular risk factors (6). This review did not include any articles that addressed mental health, quality of life, or general health.

Recent studies showed that adolescent PA has positive long-term effects on young adult PA (15, 20), physical health (21), and mental health (22, 23), while other studies found no long-term association (24, 25). In the nearly two decades that have followed the publication of the most recent systematic review, more longitudinal studies have generated new knowledge on how PA during adolescence relates to future health outcomes in early adulthood, such as mental health (22, 23), general health (26, 27), and quality of life (27). Furthermore, these studies focused on a wide variety of measures of adolescent PA, indicating that different types of PA, such as PA levels, PA domains, and sports, can have different effects on health outcomes (28–31). Most recent studies focused on the early adulthood period, therefore providing information on the transition between adolescence and early adulthood, which is marked by a shift from pediatric to independent care (32) and several important changes in health-related behaviors (33), including a marked drop in physical activity for most individuals (34). Therefore, this article aims to synthesize the new evidence from longitudinal studies on the associations between various types of PA in adolescence and the health status of young adults, including their PA level, physical health, mental health, quality of life, and general health.

2 Methods

2.1 Search method

The protocol for this systematic review is registered with PROSPERO (CRD42024553307) and follows the PRISMA guidelines (35). A medical research librarian helped develop the search strategy. The literature was reviewed using the AMED, Medline, CINAHL, and APA Psychinfo databases. Each database was searched using terms representing the following five concepts (with variations of terms used): PA (physical activit; exercise; sport; active lifestyle), adolescence (adolescen; teen; youth; young; child; early), health status/quality of life (health; mental; functional; condition; status; level; overall; qualit of life; well being; psychological well-being), early adulthood (adult; young adult), and longitudinal (longitudinal; association; follow-up; longitudinal studies). The complete search strategy is available in Supplementary Table S1. The search was finalized in December 2024 with an update in March 2026.

2.2 Inclusion and exclusion criteria

Articles in English and French (because of feasibility constraints related to language proficiency within our team) were included if they measured the association between adolescent PA (aged 12–17) and health status in early adulthood (aged 18–29). Only longitudinal studies with at least two measurement points, including at least one during adolescence (aged 12–17) and one in early adulthood (aged 18–29), were considered. Articles were excluded if we were unable to extract and isolate results on the association between adolescent PA and markers of young adult health, such as physical activity, physical health, mental health, quality of life, or general health. Studies using varying terminology or age cut-offs to define the study periods were included when the exposure and outcome assessments fell within, or predominantly within, the predefined range for each period.

PPWR led the review process by designing the search method in collaboration with the medical research librarian and assessing the eligibility of all identified articles by reviewing either the abstract or the full text for each article. To ensure consistency and minimize selection bias, a second reviewer (SB or MB) independently co-screened a random sample of 20% of the identified records using Covidence. Inter-reviewer agreement for article eligibility exceeded 99%, and disagreements were resolved through discussions until consensus was reached. SM and MB oversaw the entire process.

2.3 Information extraction

For each article included in this review, we extracted information such as the authors, study country, year, study sample, study design, measures of PA in adolescence and health in early adulthood, as well as the main findings relevant to the association between PA in adolescence and young adult health. Information was extracted by PPWR and one other author (FG, PT, DS, PF, MB or SB) for each article. The author's agreement exceeded 90% for this extraction, and disagreements were resolved through discussions among the authors.

2.4 Quality of articles

The Critical Review Form for Quantitative Studies, developed by the McMaster University Occupational Therapy Evidence-Based Practice Research Group, was used to assess the quality of the included articles (36). This tool was selected because it provides a broad assessment of overall methodological quality rather than focusing on design-specific criteria or narrowly defined domains of risk of bias. Quality appraisal was conducted independently by two authors (PPWR and either FG, PT, DS, PF, or SB) using six quality dimensions: Purpose (1 criterion), Literature (1), Design (1), Sample (2), Outcomes (2), Results (4), and Conclusions (1). The overall quality score for each article was calculated as the proportion of criteria met, based on a total of 12 items (37). Articles were categorized as low quality (<7), moderate quality (7–9), or good quality (>10) in accordance with published thresholds (38). Inter-rater agreement exceeded 95% and all the discrepancies were resolved through discussions among the authors.

2.5 Data synthesis and analysis

The included articles have been categorized by year of publication, region, study design, sample size, whether the PA measure was direct or indirect in adolescence, the number of PA measurements in adolescence, the characterization of PA in adolescence, and the outcomes measured in early adulthood. Categorization of the health outcome was based on the previous systematic review (6).

Findings from the included articles were summarized with narrative syntheses for each health outcome category. Given the heterogeneity in study designs and outcome measures, we applied the vote counting approach based on the direction of effect within each study to summarize associations between adolescent PA and health outcomes (39, 40). This approach allowed us to classify the direction of the association within each article as positive, negative, null or mixed. When studies reported multiple measures of the same outcome, we summarized findings according to the criteria proposed by boon and Thomson (39). Specifically, if all measures demonstrated effects in the same direction, an overall direction of effect was assigned. If effect directions varied across measures, the overall direction was determined when at least 70% of the measures aligned in the same direction. When fewer than 70% of the measures showed consistency in direction, the findings were categorized as mixed effects. Mixed-effects results were further classified to reflect the nature of observed associations. The included “mixed positive—null” when only positive and null associations were reported, “mixed negative—null” when only negative and null associations were observed, and “mixed positive—negative” when both positive and negative associations were present. To enhance interpretability, synthesis results were interpreted in conjunction with study quality, sample size, and consistency of findings across studies. Finally, analyses were stratified according to the characterization of PA during adolescence (sports participation, specific PA, PA level, PA education classes, leisure-time PA, and active commuting).

3 Results

We identified 5,188 articles from the literature search. After removing articles in languages other than French and English (n = 104 articles), duplicates (n = 76), and articles that did not include adolescents and young adults (n = 2,060), 2,948 articles were retained (Figure 1). These were screened by reading either the abstract or the full text, and 46 articles met the inclusion criteria. Of these, two articles were excluded because it was impossible to isolate results on the association between adolescent PA and young adult health. Therefore, the results from 44 articles are presented below.

PRISMA 2020 flowchart illustrating the article selection process.
Figure 1. PRISMA 2020 flowchart illustrating the article selection process.

The 44 articles included prospective studies conducted in America (n = 23 articles), Europe (n = 17), and Oceania (n = 4) (Table 1). There are no results from developing countries.

Table 1. Characteristics of articles included in the review (n = 44).

CharacteristicsValuesn (%)References
Year of publication2002–201010 (23%)(24, 25, 41–48)
2011–202020 (45%)(17, 21, 22, 26, 49–64)
2021–202414 (32%)(20, 23, 27, 65–75)
RegionEurope17 (39%)(24, 27, 41, 43, 45, 46, 48, 51, 54, 55, 59, 60, 65, 66, 68, 69, 74)
America23 (52%)(20–23, 25, 26, 42, 44, 47, 50, 52, 53, 56, 57, 61–64, 67, 70–73)
Oceania4 (9%)(17, 49, 58, 75)
Sample sizeLess than 50014 (32%)(24, 25, 41–43, 45, 52–54, 65, 66, 68, 69, 72)
501–1,0009 (20%)(20–23, 26, 50, 56, 67, 73)
1,001–2,0006 (14%)(17, 49, 55, 59, 60, 74)
More than 2,00015 (34%)(27, 44, 46–48, 51, 57, 58, 61–64, 70, 71, 75)
Measures of PA in adolescenceDirect measure only3 (7%)(51, 66, 69)
Self-reporting only39 (89%)(17, 20–27, 41–50, 52–64, 67, 70–75)
Both2 (4%)(65, 68)
Number of times PA was measured in adolescence123 (52%)(24, 25, 27, 41–45, 47, 48, 54, 55, 57–59, 61, 64–66, 68–70, 74)
23 (7%)(60, 62, 63)
More than 218 (41%)(17, 20–23, 26, 46, 49–53, 56, 67, 71–73, 75)
Types of PA in adolescenceActive transportation2 (4%)(65, 68)
PA levels26 (59%)(24, 25, 27, 41–43, 45, 46, 48, 49, 51–53, 59, 62–69, 71, 73–75)
PA education class2 (4%)(47, 68)
Sport participation15 (34%)(17, 20, 22–24, 26, 44, 54, 56–58, 65, 68, 70, 72)
Leisure time PA4 (9%)(54, 55, 60, 71)
Specific PA4 (9%)(21, 44, 47, 50)
PA resources1 (2%)(61)
Methods used to represent PA in adolescenceNothing (one measure)23 (52%)(24, 25, 27, 41–45, 47, 48, 54, 55, 57–59, 61, 64–66, 68–70, 74)
Trajectory5 (11%)(17, 20, 49, 51, 75)
Aggregation9 (21%)(21–23, 46, 50, 52, 53, 56, 71)
Other7 (16%)(26, 60, 62, 63, 67, 72, 73)
Outcomes measured in early adulthoodPhysical activity18 (41%)(17, 20, 26, 41, 42, 44–46, 49–51, 53, 62, 64–68)
Physical health17 (39%)(17, 20, 21, 24, 43, 45–47, 49, 51–55, 59, 61, 69)
Mental health18 (41%)(17, 22, 23, 26, 48, 49, 55–58, 60, 63, 70–75)
Quality of life3 (7%)(25, 27, 73)
Subjective health5 (11%)(17, 26, 27, 44, 75)

PA, physical activity.

Of the 44 articles, 23 used only one measure of adolescent PA to investigate its association with health outcomes in young adults. PA in adolescence was measured as PA level in 26 articles (59%) and sports participation in 15 articles (34%). Four articles presented specific PA (i.e., running, dancing, exercising), four measured leisure-time PA, two described active transportation, two assessed PA education classes, and one presented school and neighborhood PA resources. PA in adolescence was most frequently measured (n = 39) using self-reported measures. The outcomes assessed in early adulthood fit in five categories: physical activity (n = 18; Supplementary Table S2), physical health (n = 17, Supplementary Table S3), mental health (n = 18, Supplementary Table S4), quality of life (n = 3, Supplementary Table S5), and general health (n = 5, Supplementary Table S6).

3.1 Critical appraisal of articles

None of the articles retained in the analyses were of low quality; 25 (57%) were of moderate quality, and 19 (43%) were of good quality (Table 2). The quality of the 44 articles is independent of the publication period (categorized by decade) or the continent where the studies were conducted. All articles included a clear purpose, relevant background literature, good design, and an appropriate conclusion. However, quality-related appraisal points were often lost for the sample criterion, with only four articles (9%) justifying the sample size, and for the results criterion, with only one article (2%) reporting the clinical importance of the results. Further, only 18 articles (41%) reported on participants' dropout.

Table 2. Critical appraisal of the quality of articles included in the review.

Authors (year)PurposeLiteratureDesignSampleOutcomesResultsConclusionsTotalaQuality
123456789101112
Agans et al. (2017) (26)✓✓✓✓⮾↔↔✓✓⮾✓✓9Moderate
Aira et al. (2023) (65)✓✓✓✓⮾✓✓✓✓⮾⮾✓9Moderate
Aira et al. (2021) (68)✓✓✓✓⮾↔↔✓✓⮾⮾✓8Moderate
Bakken et al. (2024) (74)✓✓✓✓✓✓✓✓✓⮾✓✓11Good
Bélanger et al. (2018) (21)✓✓✓✓⮾✓✓✓✓⮾⮾✓9Moderate
Bélanger et al. (2015) (50)✓✓✓✓⮾✓✓✓✓⮾⮾✓9Moderate
Boreham et al. (2002) (24)✓✓✓✓✓✓✓✓✓⮾⮾✓10Good
Boreham et al. (2004) (41)✓✓✓✓✓✓✓✓✓⮾⮾✓10Good
Campbell et al. (2021) (42)✓✓✓✓⮾✓✓✓✓⮾⮾✓9Moderate
Clément et al. (2024) (72)✓✓✓✓⮾✓✓✓✓⮾⮾✓9Moderate
Da Silva et al. (2023) (71)✓✓✓✓⮾✓✓✓✓⮾⮾✓9Moderate
Dodge & Lambert (2008) (44)✓✓✓✓⮾↔↔✓✓⮾⮾✓8Moderate
Duckham et al. (2014) (52)✓✓✓✓⮾✓✓✓✓⮾⮾✓9Moderate
Easterlin et al. (2019) (57)✓✓✓✓⮾↔↔✓✓⮾✓✓9Moderate
Elhakeem et al. (2020) (51)✓✓✓✓⮾✓✓✓✓⮾⮾✓9Moderate
Freitas et al. (2011) (54)✓✓✓✓⮾✓✓✓✓⮾✓✓10Good
Gallant et al. (2022) (20)✓✓✓✓⮾✓✓✓✓⮾✓✓10Good
Guddal et al. (2020) (59)✓✓✓✓⮾✓✓✓✓⮾⮾✓9Moderate
Hasselstrøm et al. (2002) (45)✓✓✓✓⮾✓✓✓✓⮾✓✓10Good
Herman et al. (2010) (25)✓✓✓✓⮾✓✓✓✓✓⮾✓10Good
Hoegh Poulsen et al. (2016) (60)✓✓✓✓⮾✓✓✓✓⮾✓✓10Good
Howie et al. (2016) (17)✓✓✓✓⮾✓✓✓✓⮾✓✓10Good
Howie et al. (2020) (49)✓✓✓✓⮾✓✓✓✓⮾⮾✓9Moderate
Husoy et al. (2024) (66)✓✓✓✓⮾✓✓✓✓⮾✓✓10Good
Iverson et al. (2021) (70)✓✓✓✓⮾✓✓✓✓⮾⮾✓9Moderate
Jackowski et al. (2014) (53)✓✓✓✓⮾✓✓✓✓⮾⮾✓9Moderate
Jewett et al. (2014) (22)✓✓✓✓⮾✓✓✓✓⮾⮾✓9Moderate
Kemper et al. (2000) (43)✓✓✓✓⮾✓✓✓✓⮾⮾✓9Moderate
Kujala et al. (2007) (46)✓✓✓✓⮾⮾⮾✓✓⮾✓✓8Moderate
McPhie & Rawana (2015) (63)✓✓✓✓⮾✓✓✓✓⮾✓✓10Good
Menschik et al. (2008) (47)✓✓✓✓⮾✓✓✓✓⮾⮾✓9Moderate
Morcel et al. (2024) (69)✓✓✓✓⮾✓✓✓✓⮾✓✓10Good
Morgan et al. (2024) (75)✓✓✓⮾⮾✓✓✓✓⮾⮾✓8Moderate
Murray et al. (2021) (23)✓✓✓✓⮾✓✓✓✓⮾✓✓10Good
Niu et al. (2019) (61)✓✓✓✓⮾✓✓✓✓⮾✓✓10Good
Odling et al. (2023) (27)✓✓✓✓⮾↔↔✓✓⮾⮾✓8Moderate
Priesmeyer et al. (2019) (62)✓✓✓✓⮾⮾⮾✓✓⮾⮾✓7Moderate
Rangul et al. (2012) (55)✓✓✓✓⮾✓✓✓✓⮾✓✓10Good
Registe et al. (2025) (73)✓✓✓✓✓✓✓✓✓⮾✓✓11Good
Registe et al. (2026) (67)✓✓✓✓⮾✓✓✓✓⮾✓✓10Good
Sabiston et al. (2016) (56)✓✓✓✓⮾✓✓✓✓⮾✓✓10Good
Sagatun et al. (2007) (48)✓✓✓✓⮾✓✓✓✓⮾⮾✓9Moderate
Suetani et al. (2017) (58)✓✓✓✓⮾✓✓✓✓⮾⮾✓9Moderate
Sun et al. (2017) (64)✓✓✓✓⮾✓✓✓✓⮾✓✓10Good

(1) Was the purpose stated clearly? (2) Was relevant background literature reviewed? (3) Was the design appropriate for the study question? (4) Was the sample described in detail? (5) Was sample size justified? (6) Were the outcome measures reliable? (7) Were the outcome measures valid. (8) Results were reported in terms of statistical significance. (9) Were the analysis method(s) appropriate? (10) Clinical importance was reported? (11) Drop-outs were reported? (12) Conclusions were appropriate given study methods and results. Each ✓ means “Yes” and received 1 point, ↔ means “Some” and received 0.5, and ⮾ means “No” and received 0 point.

Total score is calculated with a maximum of 12 points possible.

3.2 Young adult physical activity

PA in early adulthood is measured as PA level (n = 14 articles), sport participation (n = 2), active transportation (n = 2), and leisure time PA (n = 1). PA level is mainly measured using an accelerometer (n = 6), the International PA Questionnaire (IPAQ, n = 5), the modified Baecke questionnaire (n = 1), or self-report of participation level per month (n = 1).

Sixteen of the 18 articles that assessed an association between PA in adolescence and PA in early adulthood supported a positive relationship between the variables. However, the strength of these associations was low to moderate, with correlations below 0.3. Seven of the 18 articles reported a “mixed positive—null” relationship between physical activity (PA) in adolescence and PA in early adulthood (Figure 2). In two articles, there was a positive association between adolescent PA and young adult self-reported PA, but not with accelerometer-measured PA in early adulthood (20, 49). In two other articles, a positive association was observed for some measures of adolescent PA, including running, and sports participation, but not for fitness and dance activities in one article (50) and moderated-to-vigorous PA (MVPA) but not light PA in another article (51). In one article, active transportation in adolescence was not associated with PA levels in young adults, but sports participation was associated with PA in early adulthood (65). In one article, the association between sports participation in adolescence and MVPA in early adulthood existed only for boys but not for girls (17). In another article, the tracking of PA from adolescence to young adulthood was fair for boys but poor for girls (41). Two articles found no association between PA levels in adolescence and PA levels in early adulthood (42, 66). One article showed that PA in early and late adolescence have different associations with PA in early adulthood (67).

Direction of the effects of physical activity during adolescence on outcomes in early adulthood.
Figure 2. Direction of the effects of physical activity during adolescence on outcomes in early adulthood.

Among all types of PA measured in adolescence with young adult PA (Figure 3), active transportation in adolescence seems to be the only type of PA in adolescence that is unrelated to young adult PA levels. Two articles based on the same study in Finland found that active transportation in adolescence (mean age 15) was not related to any trend of PA measured through an accelerometer from adolescence to early adulthood (mean age 19) (65, 68).

Direction of the effects of physical activity during adolescence on outcomes during early adulthood by type of physical activity (number of articles).
Figure 3. Direction of the effects of physical activity during adolescence on outcomes during early adulthood by type of physical activity (number of articles).

3.3 Young adult physical health

In the 17 articles examining the association between adolescent PA and early adulthood physical health, several measures of physical health were used and were classified into three groups: self-reported physical health (n = 1 article), bone mass measured with scan or x-ray (n = 4 articles), and some cardiovascular risk factors (body mass index, waist circumference, skinfold sum, cholesterol, blood pressure, type 2 diabetes, smoking, and excessive alcohol consumption, n = 12 articles).

Eleven articles report results supporting that PA in adolescence has beneficial effects on physical health in early adulthood, including seven articles with mixed-effects findings (Figure 2). Six articles reported no association, including two articles reporting no relationship between adolescent sports participation and body composition, and no relationship between adolescent PA level and blood pressure (20, 24). Two other articles found positive benefits of adolescent PA on bone size, content, and strength, but only for less than 30% of the outcomes studied (43, 52).

Each characterization of adolescent PA (Sport participation, PA education, PA level, specific PA, leisure-time PA, and PA resources) studied in relation to young adult physical health includes some articles reporting positive associations (Figure 3). Sports participation and PA levels are the only two domains with some articles reporting no association.

The only article in this review that investigated the association between PA adolescence and self-reported physical health did so via the short form of the Health Survey Version 2 (SF-12) (49). This Australian study identified that females with a high level of PA throughout adolescence had higher self-reported physical health in early adulthood than those with medium and low levels. However, there was no difference for men.

The four articles that studied the association between adolescent PA and bone measures in young adults found beneficial effects of adolescent PA on all or some of the bone measures (43, 51–53). One article from a Canadian study found that active adolescents have greater bone geometric measures, particularly at the proximal femur, in early adulthood than inactive peers (53). Another article from the UK (51) concluded that MVPA during adolescence (ages 12–16), but not light-intensity PA, is positively associated with hip bone mineral density measured by dual-energy x-ray absorptiometry scans in adulthood (age 25) for both sexes. One article showed that physically active adolescents have better tibia bone size, content, and strength in early adulthood, but no significant association was found for the other 8 of the 11 measures studied, specifically at the radius (52). The last article found that adolescents with higher PA have higher bone mineral density of the lumbar spine in adulthood, but not for mineral density of the hip, radius, and neck (43).

Eight of the twelve articles that examined cardiovascular risk factors in early adulthood showed that PA in adolescence was a protective factor for some of the outcomes measured. Body mass index (BMI) is the cardiovascular risk most studied in this review, and six of them supported that, compared to inactive peers, active adolescents have lower BMI in early adulthood. In four articles, no association was found between adolescent PA and cardiovascular risk measures in early adulthood, such as the ratio of total cholesterol with high density lipoprotein and body composition (body mass index, waist circumference, and skinfold thickness) (20, 24, 54, 69). In three of those four articles, PA in adolescence was self-reported and measured only in terms of sports participation or PA levels. In all four articles examining this association, adolescent PA is unrelated to blood pressure in young adults (20, 24, 49, 55). However, the diastolic and systolic blood pressures of the young adults measured in those four articles were normal, with little variance.

3.4 Young adult mental health

Mental health in early adulthood was assessed in 18 articles and was sometimes measured through corollaries with negative connotations, such as depression, anxiety, or stress, and other times via its positive form, such as mental well-being. Mental health measures were self-reported in all cases, and various measurement tools were used. One article on cognition is included in this summary on mental health measures.

The findings from 16 articles largely support the view that adolescent PA benefits mental health in early adulthood (Figure 2). However, seven of these articles had mixed effects because the association was present only in specific dimensions of mental health, only for some characterization of adolescent PA, or only in one sex for some measures.

Eleven articles studied depression or depressive symptoms as one mental health outcome and ten of them showed that adolescent PA was protective. Among those with positive associations, one article found an association with team sport involvement but not individual sport involvement (56) and two others found an association only for boys but not for girls (17, 49). However, one article found no association between adolescent PA and lifetime diagnosis of depression (70).

Anxiety was measured in six articles. In articles focused on the association between sports participation in adolescence and anxiety in early adulthood, two out of four found that team sport participation was a protective factor for anxiety and anxiety disorder in young adults (17, 23, 57, 58). In the two other articles, PA levels in adolescence were not related to anxiety in early adulthood (49, 71).

Four articles focused on stress as one of the mental health outcomes. One showed that participation in school sports in adolescence was related to lower stress level in early adulthood and another one found the same association with a high level of PA in adolescence (22, 23). The two other articles did not find an association between adolescent PA and stress in young adults (17, 49).

Two articles showed that longer team sports participation and PA levels during adolescence was associated with better positive mental health in early adulthood (72, 73).

Among studies investigating adolescent PA and mental health in early adulthood (Figure 3), all showed that PA level and leisure-time PA in adolescence were beneficial for mental health measures in early adulthood. Seven of nine articles showed that sports participation in adolescence was beneficial for mental health measures in early adulthood, and the two others found “no association”.

3.5 Young adult quality of life

Only three studies analyzed young adults' quality of life as an outcome (25, 27, 73). One 8-year study found that fulfilling the WHO physical activity recommendation was positively associated with health-related quality of life (27). Another study that followed participants over 13 years found a positive association between adolescent PA and Quality of Life in early adulthood, with later adolescence PA being a strong predictor of future quality of life (73). In contrast, the study with a longer follow-up found no association between adolescent PA level and young adult quality of life (25).

3.6 Young adult general health

Five articles explored the relationship between adolescent physical activity and general health in early adulthood. Three studies assessed general health using a single-question measure, one study used a three-item scale, and the fifth study employed the 12-item Self-Rated Health and Well-Being form (SF-12).

In all five articles, PA in adolescence was associated with better general health in early adulthood, despite the differing types of adolescent PA analyzed (Sports participation, PA level, and specific PA). In two of the five articles, we observed a “mixed beneficial-no effect” (Figure 2, Table 3).

Table 3. Summary of findings by outcome (number of outcomes and direction of effectsa).

Authors (year)SampleOutcomes in early adulthood
Physical activityPhysical healthMental healthQuality of lifeSubjective health
Agans et al. (2017) (26)564++ (1)++(1)++(1)
Aira et al. (2023) (65)254+(1)
Aira et al. (2021) (68)254++(3)
Bakken et al. (2024) (74)1,160++(1)
Bélanger et al. (2018) (21)589+(4)
Bélanger et al. (2015) (50)673+(1)
Boreham et al. (2002) (24)459↔(5)
Boreham et al. (2004) (41)476+(1)
Campbell et al. (2001) (42)153↔(2)
Clément et al. (2024) (72)454++(1)
Da Silva (2023) (71)3,247+(2)
Dodge and Lambert (2008) (44)8,152++(1)+(1)
Duckham et al. (2014) (52)122↔(11)
Easterlin et al. (2019) (57)4,888+(3)
Elhakeem et al. (2020) (51)2,569+(2)+(6)
Freitas et al. (2012) (54)76↔(3)
Gallant et al. (2022) (20)655+(2)↔(4)
Guddal et al. (2020) (59)1,859++(1)
Hasselstrøm et al. (2002) (45)203++(1)+(9)
Herman et al. (2010) (25)310↔(1)
Hoegh Poulsen et al. (2016) (60)1,589++(1)
Howie et al. (2016) (17)1,679+(1)+(3)↔(3)+(1)
Howie et al. (2020) (49)1,628+(2)+(20)+(6)
Husoy et al. (2024) (66)163↔(2)
Iverson et al. (2021) (70)2,318↔(2)
Jackowski et al. (2014) (53)104++(1)++(6)
Jewett et al. (2014) (22)853++(3)
Kemper et al. (2000) (43)↔(4)
Kujala et al. (2007) (46)4,240++(1)++(1)
McPhie and Rawana (2015) (63)3,676++(1)
Menschik et al. (2008) (47)3,345++(1)
Morcel et al. (2024) (69)215↔(1)
Morgan et al. (2024) (75)9,353+(3)++(1)
Murray et al. (2021) (23)733++(4)
Niu et al. (2019) (61)14,625+(1)
Odling et al. (2023) (27)2,268++(1)++(1)
Priesmeyer et al. (2019) (62)20,179++(1)
Rangul et al. (2012) (55)1,869+(7)++(1)
Registe et al. (2025) (73)541++(1)++(1)
Registe et al. (2026) (67)530++(1)
Sabiston et al. (2016) (56)860+(1)
Sagatun et al. (2007) (48)2,433+(3)
Suetani et al. (2017) (58)3,493+(6)
Sun et al. (2017) (64)5,381++(1)

++ Indicates a beneficial association; ↔ indicates no association;+indicates mixed of beneficial association and no effect. The numbers in parentheses represent the number of outcomes assessed in this article.

4 Discussion

This systematic review synthesized evidence on the association between PA during adolescence and physical activity, physical health, mental health, quality of life, and general health in early adulthood. It incorporates a growing body of longitudinal studies on this topic alongside the emergence of the life-course perspective. Our results are consistent with those of a systematic review dating from two decades ago, which had identified that most studies found that adolescent PA is beneficial for PA and health in adulthood (6). Those positive results reinforce the messaging that promoting PA early in life is essential for improving health conditions later in life.

The 44 articles included in this systematic review showed that PA in adolescence is consistently associated with better health outcomes in early adulthood, as expressed through higher PA levels, fewer mental health issues, increased positive mental health, better bone mineral density, good self-rated physical health, fewer cardiovascular disease risk factors, overall good general health, good quality of life, and better cognitive function. Results on these associations are particularly robust and likely cannot be attributed to a mediation through young adult PA because most studies controlled for this variable. Further, when examined separately, associations were generally in the same direction among boys and girls, suggesting that the observed relationships are broadly consistent across sexes and genders. This highlights that promoting physical activity (PA) in adolescence is likely effective in improving health outcomes in early adulthood.

One primary hypothesis that can explain the long-term effects of adolescent PA on young adults' health outcomes is the behavioral tracking hypothesis (76). This hypothesis is based on the fact that active adolescents are more likely to remain active later in life and to develop healthier behaviors, which supports health benefits throughout life (77, 78). This literature review supports that hypothesis by reinforcing the knowledge base, suggesting that PA in adolescence tracks into early adulthood. Indeed, we found that sports participation and PA levels in adolescence track from a low to moderate extent into early adulthood. That suggests that part of the PA habits acquired in adolescence persist through the transition to early adulthood (79). It is possible that PA tracked from adolescence to early adulthood because of habit formation and because PA is socially patterned (79). In this sense, it is conceivable that habit, social interactions, and networks developed through PA during adolescence continue to influence behaviors in future years (80, 81). However, we found no evidence that active transportation in adolescence is related to young adults PA levels in the two articles, from the same study, that focused on this association. Therefore, the association between active transportation in adolescence and PA levels in early adulthood needs to be studied further. Nevertheless, active transportation should continue to be promoted during adolescence, as strong evidence shows that it has positive health-related effects in the short term, notably through the promotion of higher PA levels, lower risk of smoking, better nutrition, and lower stress levels (82–85).

We found that adolescent PA benefits physical health, specifically, more PA in adolescence is associated with better bone measures and lower BMI. However, no association was found between adolescent PA and young adults' blood pressure in all four articles that focused on this association. This absence of a relationship can potentially be explained by young adults still benefiting from having strong cardiovascular homeostatic mechanisms (86) which makes PA effects difficult to detect. In fact, the blood pressure levels of participants in the studies reviewed were within normal ranges and presented little variation. Nevertheless, the acute effect of exercise on blood pressure has been previously demonstrated (87), and PA should continue to be promoted to improve blood pressure, especially in at-risk individuals.

Adolescent PA is found to be beneficial for mental health in young adults, measured either in its positive or negative forms. All types of PA studied in this review appear to be protective of anxiety, depression, or stress. To our knowledge, this is the first systematic review with a focus on this association. The effect of adolescent PA on young adults' mental health seemed to be mediated by other factors throughout the transition from adolescence to early adulthood, such as self-esteem (88), self-efficacy (89), emotional and social skills (90). As a whole, results suggest that PA practiced during adolescence can help reduce the surge of mental health issues that emerges in early adulthood (91, 92).

The strengths of this systematic review lie in the fact that it included longitudinal studies with long follow-ups, and some of them used multiple time points in adolescence, allowing for detailed descriptions of complex behaviors. Another strength of this article comes from the summary and disaggregation of the association studied by different types of PA in adolescence, allowing us to understand how various PA influence health outcomes in early adulthood. Moreover, this systematic review does not include low-quality articles. One limitation of this systematic review is that a meta-analysis was not feasible due to substantial heterogeneity among the included studies, including variations in definitions of PA during adolescence, developmental periods assessed, and measurement approaches for the same outcomes in young adulthood. As an alternative synthesis strategy, we used a vote counting approach and interpreted findings based on patterns and convergence of evidence, taking into account study quality, sample size, and consistency of results. Several studies adjusted for a range of potential confounders; however, residual confounding remains a concern. Socioeconomic status, parental education, family environment, and co-occurring health behaviours (e.g., diet, smoking, alcohol use) are closely linked to both physical activity participation during adolescence and health outcomes in adulthood. Inconsistent measurement and adjustment for these factors across studies may partly explain variability in effect estimates and likely contributed to the generally small observed associations. The current review also points to other areas requiring additional studies. For example, it is noteworthy that a large majority of studies included relied on self-report measures which may be prone to recall and social desirability bias, and none of the studies reviewed used compositional data to capture the composite nature of PA, which is a recommendation for the 2030 Global Action Plan (93). We also need to better understand and test mechanisms by which PA in adolescence has long-term effects into early adulthood and whether those gains are eventually lost after early adulthood. It should also be noted that the generalizability of the findings may be limited, as the majority of included studies were conducted in the United States, Europe, and Oceania, which may not reflect contexts in low- and middle-income countries or other geographic regions. Further, the review was limited to studies published in English or French, which may have resulted in the exclusion of relevant evidence published in other languages.

5 Conclusion

This systematic review provides an update on the state of knowledge on longitudinal associations between adolescent PA and health outcomes in early adulthood. Overall, the results offer limited by consistent support for a favorable association between PA during adolescence and subsequent health in early adulthood. With the exception of active transportation, participating in most types of PA in adolescence appears to confer small beneficial effects across health outcomes in the future. Ultimately, the results of this review support the potential importance of promoting physical activity throughout adolescence for health in early adulthood.

Correction Note

A correction has been made to this article. Details can be found at: 10.3389/fradm.2026.1961354.

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Supplementary material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fradm.2026.1808570/full#supplementary-material

Supplementary material Supplementary material at the source

Footnotes

Edited by: Xabier Río, University of Deusto, Spain

Reviewed by: Alain Garalde Gorostola, University of Deusto, Spain

Janet Fernandez, University of Malaysia Sarawak, Malaysia

Abbreviations BMI, body mass index; MVPA, moderate to vigorous physical activity; PA, physical activity; UK, United Kingdom; SF-12, short form of the health survey—version 2; WHO, World Health Organization.

Statements

Conflict of interest

The author(s) declared that this work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Funding

The author(s) declared that financial support was received for this work and/or its publication. This research did not receive any specific grants or funding from public, commercial or non-for-profit agencies; however, it is noted that this work was completed as part of a doctoral thesis (PPWR) funded by the “Centre d’Excellence de l’Université de Sherbrooke en Diabète, Obésité et Complications Cardiovasculaires (CEUSDOCC)” and the IMPACTS lab. The funding organizations were not involved in any stage of the study.

Author contributions

PR: Conceptualization, Data curation, Formal analysis, Methodology, Visualization, Writing – original draft, Writing – review & editing, Project administration. SB: Writing – review & editing, Data curation, Investigation. FG: Writing – review & editing, Data curation, Investigation. PT: Writing – review & editing, Data curation, Investigation. DS: Writing – review & editing, Data curation, Investigation. PF: Writing – review & editing, Data curation, Investigation. SM: Supervision, Writing – review & editing. MB: Funding acquisition, Investigation, Project administration, Supervision, Writing – review & editing, Conceptualization, Methodology, Validation, Visualization.

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Citation

Registe, P. P. W., et al. (2026). Long-term associations between physical activity during adolescence and health in early adulthood: a systematic review. Frontiers in Adolescent Medicine, Volume 4. https://doi.org/
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4 - 2026

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© 2026 Registe, Black, Gallant, Tanguay, Saucier, Faivre, Mekari and Bélanger.

License: https://creativecommons.org/licenses/by/4.0/

*Correspondence: Mathieu Bélanger

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