Chapter 31
Lifestyle+ — 22
Review of these data in aggregate prompted me to get into regular resistance and strength training, four to five times a week, for at least twenty to thirty minutes. If I’m going to be old, I’d rather be strong and old! I also opted to get a dual-energy X-ray absorptiometry scan, which can be obtained at relatively low cost (approximately $50–$75) to measure my bone density, muscle mass, and fat mass. My results are shown in figure 3.7. I don’t understand why this test is not available or used in many medical centers, as it conveys so much useful information.
As discussed with protein intake related to preservation of muscle mass, grip strength, which is representative of overall strength, is an important prognostic metric. Unlike the curve for resistance training, the relationship between grip strength and all-cause mortality reduction is linear (fig. 3.8), as determined from forty-eight studies with over 1.1 million participants. Every 5 kilograms of hand grip makes a difference, and there are many ways your hand grip can be strengthened by squeezing stress balls or a tennis ball, or by using a pull bar at a gym, at least ten times a set, five to ten times a day. The three major types of grip strength are crush, as in twisting a cap off a bottle; support, as in holding onto an object like groceries; and pinch, holding a pen between fingertips and thumb. After the age of fifty, we lose an average of over 2 percent of grip strength per year. A good move is to get a dynamometer—they are not expensive—test your grip strength, and work on getting it up to a higher level. The simple stress or tennis ball exercises should kick in within a couple of weeks. By itself, it may not have a material impact on your health span, since the association between grip and survival is not, by any means, established as cause and effect. But, at the least, it’ll help with many practical tasks for years to come.
Figure 3.7. Results of my DEXA scan
Figure 3.8. The relationship between handgrip strength and all-cause mortality. Adapted from Ruben Lopez-Bueno et al., “Thresholds of handgrip strength for all-cause, cancer, and cardiovascular mortality: A systematic review with dose-response meta-analysis,” Ageing Research Reviews 82 (December 2022): 101778, https://doi.org/10.1016/j.arr.2022.101778.
Before we leave types of exercise, we need to get into balance, best assessed by the one-leg stand test, adjusted for age. If you’re sixty years and older, you should be able stand for thirty seconds or more. For a forty- or fifty-year-old, the goal would be at least forty-five seconds. As with grip strength and resistance training time, there is an association with all-cause mortality for people who cannot do a one-leg stand for ten seconds: it doubles. Balance can be improved by practicing one-leg stands or heel-toe walking. Stretching exercises, such as a forward bend, or with Pilates or yoga, helps flexibility.