The 10-Year-Old Study That Predicts Death Better Than Blood Pressure

[00:00:00]Would you believe me if I told you that one of the best predictors that we have of how long you're going to live has almost nothing to do with your cholesterol, your blood pressure, or any expensive scan that a hospital can actually run for you, but everything to do with the strength of your own two hands. Now, it sounds, you know, a bit far-fetched until you sit with the evidence and until you happen to know somebody who very much proves this point every day of his life. Now, as I'm recording this, my father-in-law Paul is up on our roof. He is 67 years old. And literally, as we speak right now on this windy day in Yorkshire, he is fitting really heavy Yorkshire stone roof tiles on our roof. you know, these really, really big, super heavy ones, close to around a meter across and almost one and a half meters tall and they weigh around 30 or 40 kilos each. He is lifting and placing these on our roof while balancing on around a, you know, 30° pitch, you know, trying not to lose his balance, using all of the muscles in his body. He is incredibly strong. And his forearms are actually wider than his upper arms. and his hands are literally the size of a dust bin lid. He has been so active across his life that he looks a bit strange compared to somebody else of his age. Now, as somebody who's read Harry Potter more times than I would care to admit, whenever Hagrid's hands get described as duspin lids, my father-in-law is precisely who I picture. You know, his hands are enormous. His forearms and wrists are enormous. They are built that way by the sheer number of things that he's done with them over the decades. So he left school at the age of 15 and he went straight onto working on a farm. And then in time over the years he became a builder which means he spent more than 50 years carrying and lifting things and climbing up things and hauling day after day after day. Now, I'm starting this video with Paul, with my father-in-law, because there is a study that I think a man like him explains far better than any graph or chart ever could. So in 2015, a team of researchers published the results of something called the Pure Study in the Lancet. It's one of the most prestigious journals we actually have. Having followed almost 140,000 people across 17 countries from wealthy nations to some of the poorest nations in the world. The measurement at the heart of this study is laughably simple in that they handed people a grip device and they asked them to squeeze it as hard as they could. They recorded that figure and then tracked those same people over the years that followed well quite simply to see who lived and who died. When that data was finally analyzed over many many years, the pattern that emerged proved incredibly difficult to ignore and in a sense reshaped the way, you know, many many doctors actually think about strength in general. So for every 5 kilo of grip strength a person was missing, their risk of dying from any cause, literally anything, rose by roughly 16%. and their risk of dying specifically from heart disease rose by around 17%. The detail that made cardiologists actually pay attention though was the comparison that these researchers were able to draw because grip strength turned out to predict death including death from cardiovascular disease more accurately than their systolic blood pressure managed to. And that is worth pausing on because we've built entire clinics, entire drug regimes and national screening programs around blood pressure. And rightly so. It is so important. Yet, here is a really cheap squeeze test quietly outperforming it as a warning sign. And this wasn't just a one-off curiosity. This has been replicated later on because later work in half a million people through the UK bio bank pointed in exactly the same direction tying a weaker grip to higher rates of heart disease and several cancers and earlier death as well. Now, this is the moment where a lot of different health channels would tell you to go out, buy yourself a dynamometer, what we call this grip strength device, and start logging a daily score. And, you know, the temptation there is really real, considering what I've just told you about grip strength. The trouble though is that if that's the only thing you take away from this video, you know, a gadget and a figure to obsess over, then you will have walked straight past the most important thing I'm trying to tell you. The number on this device, you know, the thing that measures your grip strength is really just the shadow. And the thing that's casting that shadow is what deserves your full attention. A powerful grip, whatever reading it happens to produce, is the signature of a body that has been worked very hard and fed well over a long stretch of time. And that very bluntly is the discovery buried beneath all of those statistics. You cannot revise for a grip test the night before. And no shortcut exists that hands you a strong grip by the end of the week. You can't take a supplement for this. You can't take a medication for this. Precisely because the strength in your hand is the visible tip of an entire system that took years to assemble. That is exactly why it carries so much information. This is why being strong is so complex but so important at the same time. Now a lot of us still picture muscle as you know a little more than the machinery that moves us around. You know strong biceps and strong legs that sort of thing.

[00:05:59]Useful for carrying you know the shopping from the car into the house but not much else beyond that. But that picture is really really massively out of date because scal muscle we now know is one of the most metabolically active tissues in the entire body. And in many respects it behaves like an organ in its own right. And this gives us a bit of a clue to what I'm going to talk about next because muscle isn't just about being strong. It paints a picture about your overall health in every single organ in your body. So consider what happens with sugar for instance. So after a meal, the single largest size where your body stores that sugar that you've just absorbed from your carbohydrates is your skeletal muscle, the muscle on your skeleton, the stuff that you can see. And the more of it you carry, like Paul, my father-in-law, who has a lot of muscle, then the more of it you put to work and the larger and more responsive that storage capacity becomes. Basically, the more sugar you can remove from your bloodstream because sugar in your blood is bad. A well muscled and wellused body therefore draws blood sugar out of the circulation very quietly and it keeps your insulin levels much lower as well. Whereas a wasted sedentary body basically what most of my generation are going to become because we've all sat down for all of our lives. We've got sofas to sit on and watch Netflix. We've got commuting in the car. No, we eat crap all the time as well. These sorts of bodies has nowhere to put that glucose.

[00:07:28]So it lingers in the bloodstream and over the months and years that excess sugar begins to latch onto proteins and onto the delicate lining of your blood vessels and making them stiffer and scarring them from the inside out. Now that very slow creeping damage is what eventually surfaces as harm to your eyes or the kidneys or the nerves and your coronary arteries as well as plaques and also the arteries feeding your brain as well. which is why people who have led a fairly metabolically unhealthy life have higher rates of Alzheimer's and cognitive decline and poor memory. All of these different things that we talk about. This is why muscle and strength sit so far upstream of type 2 diabetes, of fatty liver disease, and of the broad metabolic decline that underpins so much of the illnesses that we see later on in life. Alongside that sits this chemical conversation that muscle takes part in as well. So every time a muscle contracts, it releases signaling molecules into your bloodstream known collectively as myioines. Now myioines are amazing. They are fantastic. And the more muscle that you have, the more myioines that you can release. And these travel out to your fat tissue, to the liver, to the blood vessels, and even your brain with many of them acting to calm inflammation down rather than feed it. A body that contracts hard and often is in effect dosing itself with these beneficial signals on a regular basis.

[00:09:02]While a body that stays still simply goes without these protective things, which means the strong grip is also reporting a bit indirectly on years of that internal chemistry running in your favor. Now, we had our Land Rover Discovery serviced a few weeks ago. I had a few problems with it. It was sitting in the garage for about 3 or 4 weeks. And being a diesel vehicle that had basically sat still for almost a month. When we collected it and then finally drove it back, a huge gray cloud of black smoke came pouring out of the exhaust purely because the engine had been left to sit idle for a number of weeks. And you expect these sorts of things from a diesel vehicle. And the body works in pretty much the same way.

[00:09:45]If you leave the machinery unused, then things will quietly start to go wrong with it. Whereas, if you keep running it regularly like a diesel car, then it will stay clean and responsive and efficient as well. Now, beyond all of that, your muscle quietly performs one more job, and it's the one you'll be most thankful for if you ever find yourself seriously unwell. So it acts as a protein store, a reserve that your body can draw on in a crisis. So when you fall properly ill, whether that's a pneumonia or breaking a hip or a palenritis or a kidney infection or fighting off sepsis, your body shifts into a breakdown state in which it starts dismantling its own tissue to fuel the immune response and the work of repair. And the first tissue it turns to is muscle. And this is why we see elderly people that have been admitted and can't be discharged because there are no beds in the nursing homes available. They develop something called pajama paralysis where they come in following a very simple fall having been fairly active and they leave the hospital unable to walk because they've lost so much muscle. So, somebody who walks into that crisis carrying plenty of muscle has a very deep reserve to spend, which means they can afford to lose some and recover and get back on their feet and eventually leave the hospital under their own steam. Somebody who arrives at the hospital already depleted and frail and pretty low on muscle can be pushed over that edge by precisely that same illness past that red line. Losing the tiny amount of muscle that they had, struggling to stand and then entering a downward spiral that is very hard to escape. And like I just said, this goes a very long way towards explaining why frailty and low muscle mass predict poor survival across well pretty much every condition that we see, including plenty that have no obvious connection to strength at all, like a chest infection or like a wrist fracture. And grip strength happens to be one of the clearest windows that we have into how much of that reserve a person is carrying. You know, if a person has been active across their whole life, if they've been gardening and carrying things or done a job that requires moving around every day, if they have a strong grip, then they're probably going to have strong legs and a strong core and strong shoulders as well. Grip strength on its own is a proxy for everything else. I hope that makes sense. And this is where my father-in-law comes back into this story because the reason he can move huge tiles weighing around 30 or 40 kilos, they're literally about an inch thick, you know, around a roof at the age of 67 owes very little to any clever training program and almost everything to the fact that he has loaded his body really hard on nearly every single working day since he was 15 years old.

[00:12:43]And your bones directly respond to that kind of demand, laying down extra material along the lines of greatest stress, so that it grows denser and stronger over time, while your tendons and your connective tissue become a lot thicker and toughen in parallel alongside all of that. So basically, all of your bones in your body will have some sort of muscle originating from it or pulling on it, inserting from it. So when you're moving all day every day, all of those points of insertion or origin means that the bone around it will become stronger because it's needing to be stronger because the muscle that's growing is pulling on it.

[00:13:24]And the last thing you want is your bone sort of shearing off. Obviously, that doesn't really happen, but you see what I'm saying here? Stronger muscles means stronger bones because the muscles are attached to the bones. The nervous system, meanwhile, becomes steadily better at recruiting muscle fibers.

[00:13:42]firing them into unison and producing, you know, the force the moment it's called for, which matters a huge deal since strength is as much a skill of the nervous system as it is a question of sheer size and strength. And that skill is sharpened by the decades of repeated use. Basically, what this means is that if you take two people age 70, one of them is really strong and fit and has stayed active their whole life, and you've got a person who hasn't done anything for 50 years, both of them are sort of nudged or tried to be pushed over. Well, the person who is stronger will have faster reflexes. They will have faster muscle reaction times. And so they may sort of prevent a fall that for the other person could shatter a hip or shatter their skull and cause a bleed on the brain. Remember that muscle clings onto its bulk and to its fast powerful fibers far more stubbornly in a body that keeps making demands of it in a body that keeps using it. And the contrast with, you know, somebody that doesn't use their muscle could, you know, hardly be any sharper. So from somewhere around the age of 30, an inactive person tends to shed between 3 and 8% of their muscle every single decade. The number is a bit debated, but let's just go with that. But the loss accelerates after the age of 60 unless you do something about it. And obviously that decline is much more common in people that don't use their body. So, somebody who farms from a young age and then starts becoming a builder and spends every working day mixing barrels of cement or, you know, building walls or dry stone walling or putting a new roof on a farmhouse. You know, somebody handing their body a fresh reason every single day to hold on to its muscle.

[00:15:26]Well, that instruction to keep muscle never switches off. And there's even evidence that muscular strength measured all the way back to adolescence to teenage years predicts how long men go on to live, which tells you, you know, this is a thread running through the whole of life rather than just something that only begins to matter once you're old. As with everything I talk about on this channel, the earlier you start, the better. But that's not to say that if you're 60 or 70 now, then it's too late.

[00:15:58]Far from it. you can still make real real gains and make a massive difference. The thing is though, you can work your body every single day as often as you can. You can load your body up day after day after day, but if you fail to feed your body properly, you will never build the muscle that you're capable of because that hasn't got the raw ingredients it actually needs. And this is the well-nourished half of the picture. And it grows more important with age rather than less important. So maintaining muscle requires a very steady supply of protein along with enough overall energy to support that process. And as we become older, your body becomes a bit sort of hard of hearing to the signal that protein normally sends to build and repair tissue. And I've mentioned this before.

[00:16:44]It's something that we call anabolic resistance. Now, the practical consequence is that older people frequently need more protein in a given meal compared to younger people, you know, to achieve the same effect. And that is precisely the opposite of the way that many people tend to think as they get older. They think, well, you know, I've made all of my muscle. I'm never going to get any bigger. You know, I can just eat what I like. Whereas, in reality, they need more protein than they did 20 or 30 years ago. Now, a man like Paul who has eaten like a working countryman for half a century, sitting down to proper meals built around plenty of fresh food and protein and meat and all of this sort of stuff. You know, food that matched the labor that he was doing, he has been quietly feeding that muscle the whole time. So, the grip he carries at 67 is the compound interest that he's earned on decades of loading and feeding combined. And that is something that you cannot purchase in a month or you know supplement your way into in a hurry since it can only ever be earned pretty slowly. And look the obvious question is where does this leave you if you've never actually happened to spend your life on a farm or on a building site. You never really used your body. And the honest answer is that you know this system that produces a strong grip remains open to you at pretty much any age. Even people in their 80s and 90s can build real muscle and strength when they train against resistance and they eat enough protein to support it. So that door doesn't close firmly at the age of 50 or 60. You can make a difference at any age. And a small handful of clear principles follows on from everything that we've covered in this video so far. So the most obvious one is to lift things on a regular basis at least three times a week if you can and you need to make sure that at least some of that lifting is heavy enough you know to be properly difficult since the body only really keeps the capacity that you keep demanding of it. So you want to try and carry, you know, like big heavy things as often as you can in the way a builder or a farmer does without a second thought because that kind of real world carrying trains the hands, the trunk, you know, the whole supporting chain going down your core and your back all at once. Now obviously you're not going to be buying, you know, huge dumbbells to carry around the house. So, this could just be as simple as doing a few squats, a few pressups and a few pull-ups if you can, maybe assisted with a resistance band, you know, attached over the top and then under your feet a few times a week. The best thing you can do really is probably start a gym membership and get a personal trainer if you can afford it. Obviously, it's not essential, but doing something regularly and perhaps under a bit of supervision if you're a bit nervous or not used to this sort of thing. You know, there are lots of different ways you can approach all of this. The other one is to actually eat enough protein and spread it very sensibly across your entire day and give it more attention as the decades accumulate rather than less attention. And you should be aiming for really at least 1.2 g of protein per kilo of body weight spread across the day. And if your kidney function is fairly normal for your age, then it's unlikely to cause any problems. If you're concerned about protein intake and kidney damage because of what you've read online, then go to your doctor and have it checked and they will discuss with you sort of the levels of protein intake that are suitable for you. Above all though, the most important thing to remember, as with most of the things that I talk about on this channel, is to keep all of this going across decades and decades if you can, instead of just cramming it into a frantic six week block before a summer holiday and then doing nothing for the rest of the year.

[00:20:38]Because we know that consistency is the most important thing, as it is with investing your money into anything, as it is with learning as well. If you keep things up, the benefits compound over years and years. And the point isn't that you go out and buy a grip strength machine. The point is that you do the things every single day that would cause you to have a stronger grip because we know that if you do those things, they will protect you from the things that kill us most commonly in the Western world. Basically what we're trying to do is get back to the life that our ancestors would have had where they would have moved all day every day and would have been generally strong in a way that we are just not these days. Now if you ever meet Paul and you know you shake his hand you can feel five decades sitting in that grip. His hands are enormous. They are like sausages. you know, the farm and the bricks and the timber and the stone tiles and the freezing early mornings, all of that.

[00:21:40]You know, you can feel in his grip. I don't think he's ever been to a doctor in well, as long as I've known him over the last 10 or 15 years or so. He doesn't do doctors. He doesn't like them. He doesn't check his blood pressure. He doesn't do anything. But he does the stuff that I know is protecting him all the time. And he does stuff that most people don't do these days. He stays active. He's up at 5:00 a.m. every single day and he literally doesn't stop until 6:00 or 7 in the evening. He is basically just living the way that his dad did and his granddad did and his greatgranddad did as well. The squeeze of a hand predicts how long you're likely to live so accurately because you know that single small action very quietly reports. It's a proxy on your muscle, your nerves, your metabolism, and all of these important habits all at the same time. So, do the things every single day that makes your body stronger. And I promise you, the protective effects that that has are immense. And if you do that over 10, 20, or even 50 years, then you will be a completely different person at the end of that.