Your strength needs you
Strength is the ability to apply force against an external resistance. By definition, someone who can squat 100kg is stronger than someone who can squat 50kg. As 100kg weighs more than 50kg, the former is able to apply more force than the latter. The more force we can apply, the stronger we are. And that's really all there is to it.
In real-world application, strength is the key determinant in how we interact with our environment. Being 70 years old, wanting to pick up your grandchildren? Getting stronger makes this job easier. Playing golf, wanting to get a better swing? Greater strength will get you there. 90 years old, wanting to get off the pot by yourself? Building up your strength even at this age allows you to do that. (I picked this example on purpose. Nothing beats a good visual).
Stronger people maintain their physical independence well into late stages of their life. They are therefore less of a burden on others than frail people are, and are able to avoid the early (and dreaded) admission to the care home. Think about this next time you see your friends and family members. Would you want them to be a burden on you?
Contrary to conventional wisdom, people in their 60's and beyond are indeed able to make tremendous progress on their strength levels. I see this day in day out coaching people at my gym. Females in their 60's deadlifting 100kg, squatting 60kg, and bench pressing up to 50kg. Males in their sixties deadlifting in the mid-hundreds, squatting in the low hundreds, and benching in the 80's. Hell, even a client who is now 75 years old had built muscle by doing nothing but heavy 3's and 5's on compound lifts. Living proof that it really never is too late to start getting stronger.
It doesn't stop here, though. Physical strength is not just important for making our everyday life easier. It also helps us to live a healthier life by building up our resilience to chronic disease. And by that I mean any long-term condition you can think of. Well, at least the ones who are most likely to kill us: heart disease, cancer, diabetes, frailty, as well as the dreaded case of sarcopenia.
In fact, there isn't a single chronic condition which strength and muscle mass do not play a key role in – whether in its prevention, or in its management.
How important physical strength for many aspects of our longevity really is, we find out in Part 2.
Part 2: Strength, Muscle, and LongevityIn Part 1, we discussed the importance of physical strength in making our everyday life easier. Whether we want to perform better at a sport, or simply be able to do our gardening with greater ease at the age of 70, strength is our best friend.
In Part 2, we are diving deeper into the subject of how being strong and building muscle are paramount to our longevity.
Let's break it down.
A Longer Life?
Strength is the number one physical predictor of our longevity in men and women – with stronger people having an up to 34% lower risk of dying from all causes. As muscular strength declines at a rate of 2-3% per year after the age of 50, we ought to do something to stop our body from declining into the realms of physical uselessness.
This is where being strong comes into the fore. Stronger people are provenly better at withstanding chronic illness, simply because they have more to 'fight with' in case the going gets tough.
Building Muscle
After strength, muscle mass is the number two physical predictor of longevity.
Muscle is the metabolic reservoir we need to efficiently withstand disease and illness. Building and maintaining this vital organ throughout life is closely related to better bone health, better immune system functioning, as well as managing blood pressure, diabetes, and obesity. For example, large-scale studies assessing 217,000 people over the age of 50 have shown that having low levels of muscle increases your risk of dying from all causes by 25%.
The key to building muscle is to get strong first. The stronger you are, the more tension your muscles create – which is the key driver for an increase in muscle size.
Stronger Bones
The UK healthcare system is billed a whopping £2 billion annually to bear the consequences of bone frailty.
The ramifications of having weak bones are far-reaching – with potential immobility and a loss of physical independence on the cards. For example, a study published in the American Medical Journal in 1997 showed that half of women over the age of 65 who fracture their hip are never able to walk again.
Loading the skeletal system with increasingly heavier weights over time is crucial as this stimulates osteoblast activity for better bone remodelling as well as an increase in bone mineral density.
Managing Blood Pressure
Hypertension affects around five million people in the UK, with an estimated annual spending of £2 billion on office visits, medication, and lab tests.
Strength training has been shown to be equally effective in lowering blood pressure in hypertensive people compared to the most common anti-hypertensive medications – with an average drop in systolic blood pressure of 8.85mm Hg, as well as an average decrease of 4mm Hg in diastolic blood pressure.
Stronger Immune System
Skeletal muscle produces a type of immune system modulators called myokines. One of their main jobs is to counterbalance inflammation in the body – a key driver for all but any chronic disease. A large-scale review assessing around 90,000 people showed that low muscle strength as well as low muscle mass were associated with higher levels of systemic inflammation in the body. In a nutshell: strength and muscle are highly protective in keeping illness and inflammation at bay.
Surviving Cancer
Strength training is an effective tool for cancer survivors as its physiological adaptations combat many of the common negative side effects of cancer treatments – including the loss of muscle mass and strength, as well as fatigue and pain.
Several studies carried out among people with various types of cancer have shown greater self-esteem, higher lean-body mass, a higher treatment completion rate, as well as a better quality of life score in patients who trained for strength compared to inactive controls.
Tackling Obesity
The conventional wisdom is that aerobic exercise is the solution to obesity, which dismisses the overwhelming benefits of strength training for weight loss.
Greater muscle mass equals more calories burned at rest, better insulin sensitivity, as well as a better management of glucose.
With the emergence of weight-loss drugs over the last years, it is needless to say that building strength and maintaining muscle is paramount for people who opted for these interventions to stop their body from sliding into a state of catabolism and helping them to stay physically strong and resilient.
Managing Diabetes
The financial burden of diabetes on the NHS equates to over £25,000 per minute. In total, an estimated £14 billion are spent each year on treating diabetes, with the cost of managing complications making up the largest part.
Strength training is a proven method for lowering insulin resistance, as lifting weights and the subsequent repair of muscle tissue require glucose. This process makes the cells more sensitive to the signalling of insulin.
Improving Mental Health
A key component of longevity is not just staying physically fit, but also bullet-proofing our mental health.
In an extensive review assessing 1,452 people, researchers found that strength training was not just beneficial to lowering depression symptoms, but it outperformed aerobic exercise in its effectiveness. Most strikingly, the heavier the weights subjects lifted, the stronger the effects on lowering depression were. This is likely due to a higher release of mood-enhancing brain chemicals such as dopamine, as well as building confidence and a sense of achievement in lifting heavier weights over time. "Stronger bod – stronger mind" does seem to hold true.
Looking at the available evidence, I hope it is clear to you that getting stronger is non-negotiable for improving your longevity. I would even go as far as saying that being strong is the most important element for having a longer, more productive life.
Your strength, indeed, needs you.
Will you be there?
References
A longer life?
- Larsson et al. 1979, Muscle strength and speed of movement in relation to age and muscle morphology. J Appl Physiol 46: 451–456, 1979.
- Murray et al., 1985: Age-related differences in knee muscle strength in normal women. J Gerontol 40: 275–280.
- Young et al., 1985: The size and strength of the quadriceps muscles of old and young men. Clin Physiol 5: 145–154
- Murray et al., 1980: Strength of isometric and isokinetic contractions: Knee muscles of men aged 20 to 86. Phys Ther 60: 412–419.
- Garcia-Hermoso et al., 2018: Muscular Strength as a Predictor of All-Cause Mortality in an Apparently Healthy Population: A Systematic Review and Meta-Analysis of Data From Approximately 2 Million Men and Women. Arch Phys Med Rehabil Oct; 99(10):2100-2113.
Building muscle
- Coin et al., 2000: Bone mineral density and body composition in underweight and normal elderly subjects. Osteoporos Int 11: 1043–1050.
- Ferrucci et al., 2002: A role for sarcopenia in late-life osteoporosis. Aging Clin Exp Res 14: 1–4.
- Rolland et al., 2008: Frailty, osteoporosis and hip fracture: Causes, consequences and therapeutic perspectives. J Nutr Health Aging 12: 335–346.
- Roubenoff R., 2000: Sarcopenic obesity: Does muscle loss cause fat gain? Lessons from rheumatoid arthritis and osteoarthritis. Ann N Y Acad Sci 904: 553–557.
- Toda et al., 2000: A decline in lower extremity lean body mass per body weight is characteristic of women with early phase osteoarthritis of the knee. J Rheumatol 27: 2449–2454.
- Pinsky et al., 1990: The Framingham Disability Study: Relationship of various coronary heart disease manifestations to disability in older persons living in the community. Am J Public Health 80: 1363–1367.
- Boden et al., 1993: Effects of age and body fat on insulin resistance in healthy men. Diabetes Care 16: 728–733.
- Cefalu et al., 1995: Contribution of visceral fat mass to the insulin resistance of aging. Metabolism 44: 954–959.
- Li et al., 2018: Associations of Muscle Mass and Strength with All-Cause Mortality among US Older Adults. Med Sci Sports Exerc. Mar;50(3):458-467.
Stronger bones
- Kanis, J., 2007: WHO Technical Report (Vol. 66). United Kingdom: University of Sheffield.
- Martyn-St James, M. & Carroll, S., 2021: Effects of different impact exercise modalities on bone mineral density in premenopausal women: A meta-analysis. J Bone Miner Metab 28: 251–267.
- Marques et al., 2012: Exercise effects on bone mineral density in older adults: A meta-analysis of randomized controlled trials. Age 34: 1493–1515.
- Chaconas et al., 2013: Exercise interventions for the individual with osteoporosis. Strength Cond J 35: 49–55.
- Gomez-Cabello et al., 2012: Effects of training on bone mass in older adults: A systematic review. Sports Med 42: 301–325.
- Zehnacker, CH & Bemis-Dougherty, A., 2007: Effect of weighted exercises on bone mineral density in post menopausal women. A systematic review. J Geriatr Phys Ther 30: 79–88.
- Howe et al., 2011: Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev 7: CD000333.
Managing blood pressure
- gov.uk: New figures show high blood pressure costs NHS billions each year.
- Moraes et al., 2012: Chronic conventional resistance exercise reduces blood pressure in stage 1 hypertensive men. J Strength Cond Res 26: 1122–1129, 2012.
- Terra et al., 2008: Reduction of arterial pressure and double product at rest after resistance exercise training in elderly hypertensive women. Arq Bras Cardiol 91: 299–305.
- Marcio et al., 2013: Acute and chronic effects of resistive exercise on blood pressure in hypertensive elderly women. J Strength Cond Res. Dec;27(12):3475-80.
- Gabriela et al., 2018: Effect of Resistance Training on Blood Pressure and Autonomic Responses in Treated Hypertensives. J Strength Cond Res. May;32(5):1462-1470.
- Naci et al., 2018: How does exercise treatment compare with antihypertensive medications? A network meta-analysis of 391 randomised controlled trials assessing exercise and medication effects on systolic blood pressure. Br J Sports Med. 53:859–869.
- de Sousa et al., 2017: Resistance training alone reduces systolic and diastolic blood pressure in prehypertensive and hypertensive individuals: meta-analysis. Hypertension Research (2017) 40, 927–931.
Stronger immune system
- Pedersen, B.K., Febbraio, M.A., 2008. Muscle as an endocrine organ: focus on muscle-derived interleukin-6. Physiol. Rev. 88, 1379–1406.
- Sardeli et al., 2018: Effect of resistance training on inflammatory markers of older adults: A meta-analysis. Exp Gerontol. 188-196.
Surviving cancer
- Ena et al., 2020: Resistance Training in Breast Cancer Survivors: A Systematic Review of Exercise Programs. Int J Environ Res Public Health. 17(18):6511.
- Hanson et al., 2016: The independent effects of strength training in cancer survivors: a systematic review. Curr Onc Rep. 18:31
- Courneya et al., 2007: Effects of aerobic and resistance exercise in breast cancer patients receiving adjuvant chemotherapy: A multicenter randomized controlled trial. J Clin Oncol 25: 4396–4404.
- Amitzboll et al., 2019: Effect of progressive resistance training on health-related quality of life in the first year after breast cancer surgery – results from randomized controlled trial. Acta Oncologia.
- Cramp et al., 2010: The effects of resistance training on quality of life in cancer: a systematic literature review and meta-analysis. Support Care Cancer. 18: 1367-1367.
Tackling obesity
- American College of Sports Medicine. ACSM's Guidelines for Exercise Testing and Prescription (8th ed). Baltimore, MD: Lippincott Williams & Wilkins, 2009, pp. 165–172, 232–237, 244–246, 248–256.
- Bryner et al., 1999: Effects of resistance vs. aerobic training combined with an 800 calorie liquid diet on lean body mass and resting metabolic rate. J Am Coll Nutr. 18(2):115-21.
- Kraemer et al., 2006: Chronic resistance training in women potentiates growth hormone in vivo bioactivity: characterization of molecular mass variants. Am J Physiol Endocrinol Metab 291. 1177-1187.
Managing diabetes
- Jiahao et al., 2021: Effects of resistance training on insulin sensitivity in the elderly: A meta-analysis of randomized controlled trials. J Exerc Sci Fit. 19(4):241–251.
- diabetes.co.uk: Cost of diabetes.
- Holten et al., 2004: Strength Training Increases Insulin-Mediated Glucose Uptake, GLUT4 Content, and Insulin Signaling in Skeletal Muscle in Patients With Type 2 Diabetes. Diabetes. 53(2):294-305.
- Jansson et al., 2022: Effect of resistance training on HbA1c in adults with type 2 diabetes mellitus and the moderating effect of changes in muscular strength: a systematic review and meta-analysis. Open Diabetes Research and Care.
- Pan et al., 2018: Exercise training modalities in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis. International Journal of Behavioural Nutrition and Physical Activity.
- Umpierre et al., 2011: Physical Activity Advice Only or Structured Exercise Training and Association With HbA1c Levels in Type 2 Diabetes: A Systematic Review and Meta-analysis. Journal of American Medical Association.
- Qiu et al., 2018: Exercise training and endothelial function in patients with type 2 diabetes: a meta-analysis. Cardiovascular Diabetology. 17:64.
Improving mental health
- Nebiker et al., 2018: Moderating Effects of Exercise Duration and Intensity in Neuromuscular vs. Endurance Exercise Interventions for the Treatment of Depression: A Meta-Analytical Review. Front Psychiatry. 9: 305.
