Muscle Building May Help Teens Avoid Early Death (CME/CE)

FG_AUTHORS: MedPage Today

By Cole Petrochko, Staff Writer, MedPage Today
Published: November 24, 2012
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco

Adolescents with high muscular strength had a lower risk of a premature death by age 55 or younger, researchers found.

Participants who scored the highest on knee extension and hand grip strength tests had a near 20% reduction in rates of all-cause mortality (95% CI 0.74 to 0.88), a 35% reduction in cardiovascular disease death, and 20% to 30% lower risks of death by suicide, according to Finn Rasmussen, PhD, of the Karolinska Institutet in Stockholm, Sweden, and colleagues.

Stronger teens were also significantly less likely to have any psychiatric diagnosis -- including schizophrenia and mood disorders -- at follow-up, they reported online in BMJ.

On the other hand, all-cause mortality rates per 100,000 person-years were 122.3 for adolescents with very low muscular strength and 98.9 for those with low to middle muscular strength compared with 86.9 for those with middle to very high muscular strength.

The researchers noted that in addition to traditional predictors of mortality, such as obesity and hypertension, "a low cardiorespiratory fitness level during middle or older ages has been proposed as a powerful predictor of mortality," adding that cardiorespiratory fitness has been shown to be positively related to muscular strength.

The authors gathered health data on 1,142,599 Swedish males, ages 16 to 19, through the Swedish military conscription register to evaluate any associations between early mortality (death by age 55 or younger) and muscular strength, including through all-cause mortality, suicide, heart disease, stroke, cancer, and non-intentional accidents.

Participants had knee extension, hand grip, and elbow flexion strength, as well as diastolic and systolic blood pressure, height, and weight, recorded at baseline. They were followed up until death, date of emigration, or Dec. 31, 2006, with an median follow-up period of 24.2 years.

Strength groups were divided into quartiles and the lowest strength groups were compared against the highest to determine associations for strength and mortality.

From baseline, roughly 2% of participants died (22,883). Of those, 5.5% died of coronary heart disease, 2.3% died by stroke, 14.9% died of any cancer, 22.3% died by suicide, and 25.9% died in accidents.

The risk of death by any cause was reduced significantly by 22% to 16% among participants with the highest strength measures. Further analyses showed an inverse association between muscular strength and all-cause mortality within body mass index (BMI) groups.

Cardiovascular mortality risks were only associated with muscular strength after adjustment for BMI and diastolic blood pressure. High muscular strength was significantly associated with reduced cardiovascular mortality risks by 35%, 60% to 70% in low BMI groups, and 35% to 45% in low diastolic blood pressure groups.

High muscular strength was also significantly associated with reduced suicide death risks, but had no significant associations with cancer deaths.

The authors noted that the effect sizes for mortality associations and muscle strength were "similar to those of classic risk factors, such as BMI and blood pressure," and that these associations were independent of of BMI and blood pressure.

"Although this study cannot disentangle causal pathways, physical training from childhood and adolescence seems to be needed," they wrote, adding that patients at increased mortality risk "should be encouraged to engage in exercise programs and other forms of physical activity."

The researchers found their study was limited by lack of data on young females and a lack of generalizability to other nonmilitary conscription populations. Also, they did not have data on cardiorespiratory fitness and physical activity, so they could not examine whether muscular strength was associated with premature mortality independent of these two factors.

The study was supported with grants from the Swedish Research Council and the Spanish Ministry of Science and Innovation.

The authors declared no conflicts of interest.



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