Muscular strength in male adolescents and premature death: cohort study of one million participants
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OBJECTIVES: To explore the extent to which muscular strength in adolescence is associated with all cause and cause specific premature mortality (<55 years). DESIGN: Prospective cohort study. SETTING: Sweden. PARTICIPANTS: 1,142,599 Swedish male adolescents aged 16-19 years were followed over a period of 24 years. MAIN OUTCOME MEASURES: Baseline examinations included knee extension, handgrip, and elbow flexion strength tests, as well as measures of diastolic and systolic blood pressure and body mass index. Cox regression was used to estimate hazard ratios for mortality according to muscular strength categories (tenths). RESULTS: During a median follow-up period of 24 years, 26,145 participants died. Suicide was a more frequent cause of death in young adulthood (22.3%) than was cardiovascular diseases (7.8%) or cancer (14.9%). High muscular strength in adolescence, as assessed by knee extension and handgrip tests, was associated with a 20-35% lower risk of premature mortality due to any cause or cardiovascular disease, independently of body mass index or blood pressure; no association was observed with mortality due to cancer. Stronger adolescents had a 20-30% lower risk of death from suicide and were 15-65% less likely to have any psychiatric diagnosis (such as schizophrenia and mood disorders). Adolescents in the lowest tenth of muscular strength showed by far the highest risk of mortality for different causes. All cause mortality rates (per 100,000 person years) ranged between 122.3 and 86.9 for the weakest and strongest adolescents; corresponding figures were 9.5 and 5.6 for mortality due to cardiovascular diseases and 24.6 and 16.9 for mortality due to suicide. CONCLUSIONS: Low muscular strength in adolescents is an emerging risk factor for major causes of death in young adulthood, such as suicide and cardiovascular diseases. The effect size observed for all cause mortality was equivalent to that for well established risk factors such as elevated body mass index or blood pressure.
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Muscular strength and resistance training are protective against mental illness, even independently of general physical activity.
“it should also be noted that there is now some evidence that muscular strength and resistance training also are protective against mental illness, even independently of general physical activity 88-90 .”
From A meta-review of "lifestyle psychiatry": the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders (2020) · cites this paper as [88]
The Additional analyses section reports that male adolescents with higher muscular strength were less likely to have a psychiatric diagnosis at baseline or years later. The paper does not study resistance training or establish that strength protects against mental illness independently of general physical activity; the Suicide mortality section also acknowledges possible reverse causation. (LLM, conf=0.89)
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- Authors
- Ortega, F. B., Silventoinen, K., Tynelius, P., & Rasmussen, F.
- Affiliations
- Universidad de Granada (ES)
- University of Helsinki (FI)
- Karolinska Institutet (SE)
- Corresponding author
- Rasmussen, F.
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2012-11-20
- Volume
- 345
- Issue
- nov20 3
- Pages
- e7279-e7279
- ISSN
- 1756-1833 (ISSN-L)
- PMC
- PMC3502746
- OpenAlex
- W2109995138
- Cited by
- 555
- References
- 48
- Citations by year
- 2026: 24 · 2025: 31 · 2024: 42 · 2023: 52 · 2022: 65 · 2021: 48 · 2020: 45 · 2019: 50 · 2018: 50 · 2017: 46 · 2016: 37 · 2015: 25 · 2014: 21 · 2013: 15 · 2012: 4
- FWCI
- 13.94
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Institutional Repository of the University of Granada (University of Granada) (submittedVersion, cc-by-nc)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by-nc)
- Työväentutkimus Vuosikirja (submittedVersion, cc-by-nc)
- Funders
- Vetenskapsrådet
- Ministerio de Ciencia e Innovación (RYC‐2011‐09011)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- muscle strength, adolescent physical fitness, premature mortality, suicide, cardiovascular mortality, cancer mortality, grip strength, quadriceps strength, elbow flexion strength, young adult mortality, body mass index, blood pressure, mental illness, schizophrenia, mood disorders
- MeSH terms
- Adolescent, Cause of Death, Humans, Male, Prospective Studies, Cohort Studies, Muscle Strength, Mortality, Premature
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