Shake hands

First impressions are important, and a limp handshake is not a good calling card (1). It’s not particularly good news for you either, if you have one, because it is strongly associated with early death.

Research in this area initially focused on poor handgrip as a prognostic for cardiovascular disease (CVD), but it soon broadened out. Handgrip strength, commonly used as a measure of general muscular strength, has been shown in a series of prospective studies to be inversely associated with CVD, Type 2 diabetes, cause-specific mortality and all-cause mortality outcomes (2-12), plus the closely related conditions of sarcopenia (13) and osteoporosis (14).

Low handgrip strength will make you more likely to be hospitalized earlier in life, and once you have been admitted it is a good predictor of increased complications and hospital costs (15). It is also prognostic for more complications after surgery (16), and for increased mortality after age-related trauma such as hip fracture (17).

In short, the weaker your grip on the handrails of life, the faster you slip into the grave.

The links are fairly obvious. Physical activity improves health and life expectancy (18-27) via multiple mechanisms including enhanced cardiorespiratory, muscular and therefore metabolic fitness (19-27). Handgrip strength is merely the most accessible (and so most validated) measure of muscular fitness. It is significantly protective; in hypertensive subjects, a good handgrip neutralizes the increased risk of cardiovascular death (28).

I usually insert a few sentences early in each post moaning about how things are getting worse.

In keeping with this morbid tradition there is research showing that among Millenial men, handgrip strength has fallen by as much as 15% below the standards set by their rather more robust fathers (29). No longer hewers of wood and drawers of water, modern man is more likely to be a tapper on keyboards and a swiper on Tinder, and not only his grip strength but his entire physicality has degraded. Among Millenials, the ageing process is so accelerated that their major decline in health starts at an average age of 27, a full 5 years earlier than in Gen X’ers (30).

This physical deterioration is also seen in the increasing numbers of middle-aged and elderly with sarcopenia, sarcopenic obesity and osteoporosis (ie 31, 32). Importantly, these are slowly developing disorders. The pre-clinical phases of these conditions start much earlier in life (33, 34), and all the trends are negative.

Even paediatric sarcopenia is likely becoming more widespread, due to the progressive reduction of structured physical activity in schools. This is reflected in a generational and continuing loss of physical fitness in children and adolescents (35, 36). This potentially very serious problem urgently requires further study and remedial action (37).

There is better data for older age groups. The USA army, for example, is failing to get enough recruits into boots due to the shrinking pool of physically able American youth (38, 39). It is also losing 650,000 days of work / year among active-duty troops due to obesity-related health issues (39). Over 68% of active personnel are overweight or obese (39, 40), as are 80% of veterans (41).

If future warfare is going to be waged by mechanical rather than human drones, shrinking muscles and expanding waistlines may not matter militarily. However, they will beat health and life expectancy even further down than the 2 years loss we have seen caused by the criminally inept governmental handling of Covid (42), where lockdowns have reduced fitness even further (43-45).

So, what can the owner of the limp noodle or wet fish handshake do about it?

Firstly, go back in time and tell your mother that she needs to get into shape before thinking of getting pregnant. Maternal dysnutrition, inactivity and overweight create epigenetic changes that make babies prone to becoming overweight and developing metabolic, cardiovascular and other diseases in later life (46, 47).

This is partly because those babies will be born with reduced numbers of muscle fibers (48, 49), and as children and adults they will have reduced muscle mass and function (48-50). The crucial endocrine and metabolic functions of active and well-developed skeletal muscle will be impaired, and manifest as reduced handgrip strength and reduced health expectancy (51, 52).

For those who paradoxically still do not yet will have had no access to a time machine, nutrition and exercise is even more important. If you already have one or two epigenetic strikes against you, and live in a junk food-infested, sedentary and obesogenic environment, you won’t do well at all (46-52).

You don’t have to be fatalistic, however, because your future was not necessarily written in utero.

Bio-archeologists used to think that early life adversity as measured by ie linear dental enamel hypoplasias (tiny grooves around the tooth) was a near absolute determinant of life expectancy (ie 53), but research in modern and more fluid populations suggests that a poor start can be largely or completely nullified by a healthier later life (54).

Instead of waiting for a transplant, opt for a change of heart.

Move your diet in a low-carb direction, eschew ultra-processed foods and take short walking breaks during the work day (55). These three easy steps will provide significant protection against the problems caused by your parents and our pathogenic post-modern lifestyle. If you add a comprehensive pharmaconutritional program you will create your own Blue Zone, and jump onto an even longer health/time line.

For those interested in building muscle we can return once again (56) to intermittent fasting, or time-restricted eating.

We evolved in a world of food insecurity, as did all animals, and intermittent fasting, our default mode, creates a healthier metabolic profile. Short-term fasting raises testosterone (57) and growth hormone levels (58) in normal weight men, and has been linked to improvements in body composition (59). It has even been shown to improve cognitive function (60), at least in mice.

There is evidence that taking aerobic exercise during the fasting period is helpful, and that muscle building can be further accelerated using blood flow restriction training (61, 62), so here are another couple of easy steps you can take to grow new mitochondria and muscle (63), and unchain your inner Hercules.

We should also consider the positive side of oxidative stress.

Mitohormesis (mitochondrial hormesis) describes the induction of a favorable biological response via relatively low levels of oxidative stress applied in the mitochondria. This may improve mitochondrial function and/or numbers (mitochondrial biogenesis), depending on the nutritional and energetic context, and plays a central role in blood flow restriction training (64).

As oxidative stress is involved in mitohormesis, researchers are exploring the benefits of ionizing radiation (65-68). The positive clinical effects of low-dose X-rays are being proposed as a way to enhance patient mobility (65), and have been recorded in pain management (66) and in the treatment of Alzheimer’s (67, 68). Theoretically, they should also make you fitter.

Transoceanic flights are a more expensive but also more interesting way of being irradiated (69). Alternatively, Big Pharma is working on drug shortcuts to achieve mitohormesis and mitochondrial biogenesis (ie 70), but as with all drugs you can expect a plethora of exciting adverse effects.

Setting aside the dubious pleasures of X-rays, air rage and designer pharmaceuticals, I prefer to use food-based pharmaconutrition and recommend you to the mitohormetic effects of the epicatechin gallates from green tea (71). Excellent alternatives include the metformin-like (72, 73) alkaloid berberine from barberries (74), or the saponins from Gynostemma spp (745. They are available here (76) and here (77).

This is not just a vanity project. Sarcopenia and osteoporosis are waiting for you further down the road, and will eventually steal your health and independence if some other crisis doesn’t intervene. Preventative action now will push those problems many years into the future. And because brains and brawn work very much together, it will keep your mind sharper as well (78- 80).

If all you want to do is make a better first impression, a handgrip strengthener (81) might help.

Next week: Sunshine, shadows and sleep.

References

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