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Muscle Strength is Inversely Associated with Death and Cancer in Men

Most of us decided whether we were destined for academia or athleticism long before the close of our second decade. There are notable exceptions, including Greek physician-athlete Gregoris Lambrakis (1912-1963), who garnered the gold for long jump in the Balkan Games, then ran a private clinic for underserved patients.

The British Medical Journal recently reported results from a prospective cohort study¹ of 8762 men, exploring the relationship between muscle strength and all-cause mortality. Muscle strength was quantified by leg and bench press, cardiovascular fitness by exercise treadmill. Around 19 years later, after adjusting for age, CV fitness, activity, smoking, alcohol, BMI, PMHx, and FHx CV disease, muscle strength was inversely and independently associated with death from all causes and cancer. Despite the inherent limitations in a study of this design, these results highlight the importance of muscular strength, and provide encouragement for physicians and patients alike to get strong.

¹ BMJ 2008;337:a439
Published 1 July 2008, doi:10.1136/bmj.a439
[Link to free full-text BMJ article pdf] [Medline® abstract]

Research

Association between muscular strength and mortality in men: prospective cohort study

Jonatan R Ruiz, research associate^1,2, Xuemei Sui, research associate³, Felipe Lobelo, research associate³, James R Morrow, Jr, professor⁴, Allen W Jackson, professor4, Michael Sjöström, associate professor¹, Steven N Blair, professor^3,4
1 Department of Biosciences and Nutrition at NOVUM, Unit for Preventive Nutrition, Karolinska Institutet, Huddinge, Sweden, ² Department of Physiology, School of Medicine, University of Granada, Spain, ³ Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA, ⁴ Department of Kinesiology, Health Promotion, and Recreation, University of North Texas, Denton, TX, USA Correspondence to: J R Ruiz ruizj@ugr.es

Objective To examine prospectively the association between muscular strength and mortality from all causes, cardiovascular disease, and cancer in men.

Design Prospective cohort study.

Setting Aerobics centre longitudinal study.

Participants 8762 men aged 20-80.

Main outcome measures All cause mortality up to 31 December 2003; muscular strength, quantified by combining one repetition maximal measures for leg and bench presses and further categorised as age specific thirds of the combined strength variable; and cardiorespiratory fitness assessed by a maximal exercise test on a treadmill.

Results During an average follow-up of 18.9 years, 503 deaths occurred (145 cardiovascular disease, 199 cancer). Age adjusted death rates per 10 000 person years across incremental thirds of muscular strength were 38.9, 25.9, and 26.6 for all causes; 12.1, 7.6, and 6.6 for cardiovascular disease; and 6.1, 4.9, and 4.2 for cancer (all P<0.01 for linear trend). After adjusting for age, physical activity, smoking, alcohol intake, body mass index, baseline medical conditions, and family history of cardiovascular disease, hazard ratios across incremental thirds of muscular strength for all cause mortality were 1.0 (referent), 0.72 (95% confidence interval 0.58 to 0.90), and 0.77 (0.62 to 0.96); for death from cardiovascular disease were 1.0 (referent), 0.74 (0.50 to 1.10), and 0.71 (0.47 to 1.07); and for death from cancer were 1.0 (referent), 0.72 (0.51 to 1.00), and 0.68 (0.48 to 0.97). The pattern of the association between muscular strength and death from all causes and cancer persisted after further adjustment for cardiorespiratory fitness; however, the association between muscular strength and death from cardiovascular disease was attenuated after further adjustment for cardiorespiratory fitness.

Conclusion Muscular strength is inversely and independently associated with death from all causes and cancer in men, even after adjusting for cardiorespiratory fitness and other potential confounders.

© 2008 BMJ Publishing Group Ltd.