Adequate Muscular Strength May Help to Reduce Risk of Residual-Specific Mortality: Findings From the National Health and Nutrition Examination Survey

in Journal of Physical Activity and Health
Restricted access

Purchase article

USD  $24.95

Student 1 year subscription

USD  $115.00

1 year subscription

USD  $153.00

Student 2 year subscription

USD  $218.00

2 year subscription

USD  $285.00

Objective: Muscular strength has been shown to inversely associate with mortality. The purpose of this study was to examine the association between muscular strength and residual-specific mortality among a national sample of US adults, which has yet to be investigated. Here, residual-specific mortality is identified as deaths not inclusive of the 9 leading causes of death as identified by the International Classification of Diseases, 10th revision. Methods: Data from the 1999–2002 National Health and Nutrition Examination Survey were used (N = 2171 adults, aged 50–85 y). Participants were followed through 2011, including a median follow-up of 125 months. Lower extremity muscular strength was assessed using maximal isokinetic contractions. Results: After adjusting for all covariates (age, gender, race/ethnicity, body mass index, C-reactive protein, mean arterial pressure, self-report of meeting aerobic-based physical activity guidelines, and physician diagnoses of diabetes), the Cox proportional hazard model demonstrated that for every 25 N increase in lower extremity muscular strength, individuals had a 14% reduced risk of residual-specific death (hazard ratio = 0.86; 95% confidence interval, 0.78–0.96; P = .008). Conclusion: Lower body muscular strength is inversely and independently associated with residual-specific mortality risk, underscoring the importance of adequate muscular strength to prolong survival.

Edwards and Loprinzi are with the Dept of Health, Exercise Science, and Recreation Management, The University of Mississippi, University, MS.

Loprinzi (pdloprin@olemiss.edu) is corresponding author.
  • 1.

    Healthy People 2020. Office of Disease Prevention and Health Promotion. 2016. https://www.healthypeople.gov/2020/data-search/Search-the-Data?&f[0]=field_topic_area%3A3504. Accessed January 1, 2016.

    • Export Citation
  • 2.

    Physical Activity Guidelines Advisory Committee Report, 2008. 2008. https://health.gov/paguidelines/report/. Accessed January 3, 2016.

  • 3.

    Pollock ML, Franklin BA, Balady GJ, et al. AHA Science Advisory. Resistance exercise in individuals with and without cardiovascular disease: benefits, rationale, safety, and prescription: an advisory from the Committee on Exercise, Rehabilitation, and Prevention, Council on Clinical Cardiology, American Heart Association; position paper endorsed by the American College of Sports Medicine. Circulation. 2000;101(7):828–833. PubMed doi:10.1161/01.CIR.101.7.828

    • Search Google Scholar
    • Export Citation
  • 4.

    Newman AB, Kupelian V, Visser M, et al. Strength, but not muscle mass, is associated with mortality in the health, aging and body composition study cohort. J Gerontol A Biol Sci Med Sci. 2006;61(1):72–77. PubMed doi:10.1093/gerona/61.1.72

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Ruiz JR, Sui X, Lobelo F, et al. Association between muscular strength and mortality in men: prospective cohort study. BMJ. 2008;337:439. PubMed doi:10.1136/bmj.a439

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Loprinzi PD. Lower extremity muscular strength, sedentary behavior, and mortality. Age. 2016;38(2):32. PubMed doi:10.1007/s11357-016-9899-9

  • 7.

    Bohannon R, Peolsson A, Massy-Westropp NM, Desrosiers J, Bear-Lehman J. Reference values for adult grip strength measured with a Jamar dynamometer: a descriptive meta-analysis. Physiotherapy. 2006;92(1):11–15. doi:10.1016/j.physio.2005.05.003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Gale CR, Martyn CN, Cooper C, Sayer AA. Grip strength, body composition, and mortality. Int J Epidemiol. 2007;36(1):228–235. PubMed doi:10.1093/ije/dyl224

  • 9.

    Ruiz JR, Sui X, Lobelo F, et al. Muscular strength and adiposity as predictors of adulthood cancer mortality in men. Cancer Epidemiol Biomarkers Prev. 2009;18(5):1468–1476. PubMed doi:10.1158/1055-9965.EPI-08-1075

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Xu J, Murphy SL, Kochanek KD, Bastian BA. Deaths: final data for 2013. Natl Vital Stat Rep. 2016;64(2):1–119. PubMed

  • 11.

    World Health Organization. International Statistical Classification of Diseases and Related Health Problems. No. 2, 2010 ed. Geneva, Switzerland: World Health Organization; 2010.

    • Search Google Scholar
    • Export Citation
  • 12.

    Loprinzi PD, Sng E, Addoh O. Physical activity and residual-specific mortality among adults in the United States. Med Sci Sports Exerc. 2016;48(9):1730–1736. PubMed doi:10.1249/MSS.0000000000000952

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Tredinnick TJ, Duncan PW. Reliability of measurements of concentric and eccentric isokinetic loading. Phys Ther. 1988;68(5):656–659. PubMed doi:10.1093/ptj/68.5.656

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Loprinzi PD, Crespo CJ, Andersen RE, Smit E. Association of body mass index with cardiovascular disease biomarkers. Am J Prev Med. 2015;48(3):338–344. PubMed doi:10.1016/j.amepre.2014.08.019

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Loprinzi P, Cardinal B, Crespo C, et al. Objectively measured physical activity and C-reactive protein: National Health and Nutrition Examination Survey 2003–2004. Scand J Med Sci Sports. 2013;23(2):164–170. PubMed doi:10.1111/j.1600-0838.2011.01356.x

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Loprinzi PD. Dose-response association of moderate-to-vigorous physical activity with cardiovascular biomarkers and all-cause mortality: considerations by individual sports, exercise and recreational physical activities. Prev Med. 2015;81:73–77. PubMed doi:10.1016/j.ypmed.2015.08.014

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Dankel SJ, Loenneke JP, Loprinzi PD. Determining the importance of meeting muscle-strengthening activity guidelines: is the behavior or the outcome of the behavior (strength) a more important determinant of all-cause mortality? Mayo Clin Proc. 2016;91(2):166–174. PubMed doi:10.1016/j.mayocp.2015.10.017

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Visser M, Pahor M, Taaffe DR, et al. Relationship of interleukin-6 and tumor necrosis factor-alpha with muscle mass and muscle strength in elderly men and women: the Health ABC Study. J Gerontol A Biol Sci Med Sci. 2002;57(5):M326–332. PubMed doi:10.1093/gerona/57.5.M326

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Schaap LA, Pluijm SM, Deeg DJ, et al. Higher inflammatory marker levels in older persons: associations with 5-year change in muscle mass and muscle strength. J Gerontol A Biol Sci Med Sci. 2009;64(11):1183–1189. PubMed doi:10.1093/gerona/glp097

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Paulsen G, Benestad HB, Strøm-Gundersen I, Mørkrid L, Lappegård KT, Raastad T. Delayed leukocytosis and cytokine response to high-force eccentric exercise. Med Sci Sports Exerc. 2005;37(11):1877–1883. PubMed doi:10.1249/01.mss.0000177064.65927.98

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Walsh NP, Gleeson M, Shephard RJ, et al. Position statement. Part one: immune function and exercise. Exerc Immunol Rev. 2011;17:6–63. PubMed

  • 22.

    Singh NA, Stavrinos TM, Scarbek Y, Galambos G, Liber C, Fiatarone Singh MA. A randomized controlled trial of high versus low intensity weight training versus general practitioner care for clinical depression in older adults. J Gerontol A Biol Sci Med Sci. 2005;60(6):768–776. PubMed doi:10.1093/gerona/60.6.768

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Yarasheski KE, Tebas P, Stanerson B, et al. Resistance exercise training reduces hypertriglyceridemia in HIV-infected men treated with antiviral therapy. J Appl Physiol. 2001;90(1):133–138. PubMed

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Goodwin VA, Richards SH, Taylor RS, Taylor AH, Campbell JL. The effectiveness of exercise interventions for people with Parkinson’s disease: a systematic review and meta-analysis. Mov Disord. 2008;23(5):631–640. PubMed doi:10.1002/mds.21922

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Loprinzi PD, Loenneke JP. Lower extremity muscular strength and leukocyte telomere length: implications of muscular strength in attenuating age-related chronic disease. J Phys Act Health. 2016;13(4):454–457. doi:10.1123/jpah.2015-0120

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 74 74 4
Full Text Views 0 0 0
PDF Downloads 0 0 0