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Cited by 555Physical Activity and HealthHealth disparities and outcomesCardiovascular and exercise physiology

The DOI matches its Crossref record; 48 of the 48 references it cites were found in a registry or an index.

Muscular strength in male adolescents and premature death: cohort study of one million participants

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Ortega, F. B., Silventoinen, K., Tynelius, P., Rasmussen, F.·2012·BMJ
DOI 10.1136/bmj.e7279PMC PMC3502746
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Abstract

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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Crossref · 10.1136/bmj.e7279

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Fig 1 Hazard ratios (95% CI) for relation of muscular strength, body mass index, and blood pressure with all cause premature death. Models were adjusted for birth cohort, conscription age, and conscription office (n=1 142 599)
Fig 1 Hazard ratios (95% CI) for relation of muscular strength, body mass index, and blood pressure with all cause premature death. Models were adjusted for birth cohort, conscription age, and conscription office (n=1 142 599)CC BY-NC · PubMed Central
Fig 2 Hazard ratios (95% CI) for relation of muscular strength, body mass index, and blood pressure with premature death from cardiovascular disease. Models were adjusted for birth cohort, conscription age, and conscription office (n=1 118 154)
Fig 2 Hazard ratios (95% CI) for relation of muscular strength, body mass index, and blood pressure with premature death from cardiovascular disease. Models were adjusted for birth cohort, conscription age, and conscription office (n=1 118 154)CC BY-NC · PubMed Central
Fig 3 Hazard ratios (95% CI) for relation of muscular strength, body mass index, and blood pressure with premature death from suicide. Models were adjusted for birth cohort, conscription age, and conscription office (n=1 121 480)
Fig 3 Hazard ratios (95% CI) for relation of muscular strength, body mass index, and blood pressure with premature death from suicide. Models were adjusted for birth cohort, conscription age, and conscription office (n=1 121 480)CC BY-NC · PubMed Central
Fig 4 Hazard ratios (95% CI) for relation of muscular strength, body mass index, and blood pressure with premature death from cancer. Models were adjusted for birth cohort, conscription age, and conscription office (n=1 119 790)
Fig 4 Hazard ratios (95% CI) for relation of muscular strength, body mass index, and blood pressure with premature death from cancer. Models were adjusted for birth cohort, conscription age, and conscription office (n=1 119 790)CC BY-NC · PubMed Central
Fig 5 Hazard ratios (95% CI) for relation of muscular strength, body mass index, and blood pressure, mutually adjusted, with all cause premature death and death from cardiovascular disease and suicide. Models were additionally adjusted for birth cohort, conscription age, and conscription office
Fig 5 Hazard ratios (95% CI) for relation of muscular strength, body mass index, and blood pressure, mutually adjusted, with all cause premature death and death from cardiovascular disease and suicide. Models were additionally adjusted for birth cohort, conscription age, and conscription officeCC BY-NC · PubMed Central
Fig 6 Hazard ratios (95% CI) for relation of muscular strength with all cause premature death, stratified by body mass index (BMI) categories. Models were adjusted for birth cohort, conscription age, and conscription office
Fig 6 Hazard ratios (95% CI) for relation of muscular strength with all cause premature death, stratified by body mass index (BMI) categories. Models were adjusted for birth cohort, conscription age, and conscription officeCC BY-NC · PubMed Central

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Metadata

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.
ORCID
Venue
BMJ
Publisher
BMJ
Published
2012-11-20
Volume
345
Issue
nov20 3
Pages
e7279-e7279
ISSN
1756-1833 (ISSN-L)
DOI
10.1136/bmj.e7279
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
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 › Public Health, Environmental and Occupational Health › Physical Activity and Health
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Physiology (medical) › 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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