Strength and Muscle Mass for Long Term Health

Hi docs,

I’ve read your “Strength and Cancer-related mortality” article and IIRC, a significant conclusion was that being in higher quartiles for strength was important, and falling into lower quartiles didn’t show much benefit, indicating that participation isn’t sufficient and strength is actually necessary.

In this Q&A (https://www.youtube.com/watch?v=NnwoRbswPUw) you guys mention a “threshold effect” for strength, and that very high levels taper benefits quite quickly.

Is this to say that there’s a “middle ground” whereby landing in the “well above average” strength category produces the most beneficial effect, whereas “infrequent” gym-goer levels are insufficient and elite levels of strength don’t confer much additional benefit? Or is there some difference between cancer mortality specifically and other health outcomes?

Or is it simply the case that the “upper quartile” of strength for elderly ages where chronic disease tends to hit hardest is well below elite-levels of strength, but well above the average for that age bracket (the age cutoff in the article’s study was >=50 IIRC).

Apologies if I missed something obvious!

Rohan,

An interesting question and one I’m not sure I have a satisfactory answer for.

While I feel comfortable saying there’s likely a threshold of strength above which little additional health benefit occurs, I do not know where this threshold is exactly or even what the best proxy is. For example, I think most would agree handgrip strength would not be granular enough to measure strength related to health outcomes, particularly as strength changes. I also am not confident 1RM tests on leg press and chest press (or similar) would be sufficient, as there are other types of strength that may pick up something a 1RM test misses.

If I had to design a strength battery, I’d likely have a test of dynamic maximal strength (e.g. a 1RM) that changes with training (or detraining) and a test of muscular endurance combined with relative strength (e.g. a BW test to failure).

In any case, I think the strength threshold for max health benefits is likely lower than most gym rats would predict, but also far stronger than most in the general population. I also think that for those below, at, or slightly above this range, an increase in strength likely correlates with improved health compared to strict maintenance of strength. Finally, for those far in excess of this threshold I don’t think the “extra” strength itself is health promoting, but rather the lifetime of activity they’ve exposed themselves to is likely more contributory.

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Thanks for the reply.

It at least seems safe to say that simple participation in resistance training activity isn’t quite “enough”, even if competitive-powerlifting-levels of strength don’t necessarily confer significant benefit over “well above average”. I would be curious to know whether or not rates of strength decline more significantly for one type of gym population over another and perhaps why, but I’m not sure that there would be any surprising answers there.

I think if anything it emphasizes the longterm health benefits of general athleticism before anything else. Being a 65 year old powerlifter that can still squat 500 but can barely walk up stairs, or a translucent 65 year old runner that can’t do 10 pushups doesn’t seem to be ideal from the standpoint of health considerations.

Thanks again!