Fundamental Fitness and Longevity Part I, Muscle Mass and Strength

[MateoBeach]

I am considering the topic of "fundamental" or underlying health. That is the performance and survival capacities, and the resilience of the individual to function well in life, irrespective of the presence of prostate cancer or other diseases. 

Fundamental health is certainly impacted by our habits and lifestyle choices including dietary, exercise and health maintenance choices. These may be reflected in longevity (mortality) studies as indicators of fundamental health.

Advanced prostate cancer can often be a long journey of many years. The theory is that many of the same factors that affect aging and longevity ("The Hallmarks of Aging") are similar and overlap the factors affecting the progression of prostate and other cancers. ("The Hallmarks of Cancer") So I decided look at how exercise and fitness affect longevity in older adults. Specifically, looking at muscle mass and strength in this Part 1. "Cardiorespiratory fitness will be addressed inPart 2.

 Key article: "Muscle Mass Index as a predictor of Longevity in Older Adults." 

ncbi.nlm.nih.gov/pmc/articl...  

Obesity (as defined by body mass index) hasn’t been consistently associated with higher mortality in older adults. However, total body mass includes fat and muscle which have different metabolic effects. This study was designed to test the hypothesis that greater muscle mass in older adults will be associated with lower all-cause mortality. This study looked at 3,659 participants of the NHNES Survey (1988-1994 over age 55 (I will summarize results for men. The article also has the results for women.)

Lean body mass was estimated by a biomedical impedance. Muscle Mass Index (MMI) is muscle mass / height in meters squared, analogous to BMI. Non-muscle mass, as an indicator of fat mass was determined as BMI minus MMI. Mortality rates were determined in 2004 given as deaths per 10,000 person-months. Results showed that those in the higher quartiles of MMI had significantly lower mortality than those in the lower quartiles.  

"Unadjusted all-cause mortality risk was significantly higher in the lowest muscle mass index quartile compared to the highest muscle mass index quartile (58% compared to 41%; relative reduction of 30%). However, both mortality risk and mortality rate in the third quartile were not significantly different from that in the fourth quartile." So the highest MMI quartile was not significantly different from the third. Implying that very high muscularity was not necessary, just being above the average (mean). 

And interestingly, higher non-muscle mass index (a proxy for higher fat mass) was not significantly related to longevity. "In contrast, mortality risk remained essentially unchanged from the lowest to the highest sex specific quartile of non-muscle mass index : 49.6% in the highest to 49.1% in the lowest."

Muscle was more important than leanness. Looking at BMI alone (total body weight per height, meaning Muscle Mass index plus non-muscle mass index) did not predict higher mortality. There was a small and statistically non-significant decline in mortality risk (50.5% to 45.9%) and mortality rate (36.1 per 10,000 person-months to 31.2) from the lowest to the highest quartile of BMI. As has been noted in other studies, being too lean is riskier than being overweight (if not actually obese). In Part 2, we can consider the role of cardiovascular fitness. Stay strong.

[BrentW]

I am struggling to maintain muscle mass, having been on ADT since 2004. Currently I am on enzalutamide, following four and half years on Zytiga.

I exercise regularly every morning for 30 minutes, including 3 sessions weekly with weights. Still I seem to be like the Red Queen, running on one spot just to stay where I am, maintaining what little muscle mass I have remaining.

Any thoughts?

[London441 in reply to BrentW]

Lift more weights. More frequency, but especially with greater intensity. Get a trainer if you can afford it. Also eat and sleep enough.

The ultimate ‘easier said than done’ on ADT but it does work.

[MateoBeach in reply to BrentW]

I know exactly what you mean and sympathize. One dimension and symptom of hypogonadism such as ADT is that there is a reduced muscle building and muscle maintaining effect of resistance training including heavy weight training. I saw this happen with very intense and heavy training with a very good trainer. Sarcopenia slowly progressed anyway. Finally reversed it quickly when I went on high testosterone replacement with BAT. It seems there is quite a range of variability in this, with some apparently not so much affected.One day we will likely have SARMs approved that do not have significant effects on PC growth, but support muscle, nerve and brain functions mediated by androgen receptors. Personally, I could not wait for that.

[BrentW in reply to MateoBeach]

I am glad to know I am not alone, but would not wish to risk testosterone supplements. Isn't reducing that hormone much of what ADT is about? I have a phone call with my oncologist today. I shall mention this issue to her.

[middlejoel]

So, I just turned 86. I lost 20 lbs after I went on Lupron and friends some years back. Eat a very healthy diet. Walk my dog for about 45 mintes twice a day. I am not scary skinny but I guess that I could be considered lean. I HATE WORKING WITH WEIGHTS and have my whole life. Am I making a choice of quality over quantity?

[MateoBeach in reply to middlejoel]

You might want to look into what I am doing and testing now. The Big 5 Workout carefully explained in the book Body By Science. 5 exercises done one set only forMaximum of 2 minutes, no more often than

Once per week. But done with very slow movements at high intensity. That is 10 minutes of work in about 15 minutes in a gym once a week. With very powerful results. Worth it!

[MateoBeach]

You might want to look into what I am doing and testing now. The Big 5 Workout carefully explained in the book Body By Science. 5 exercises done one set only forMaximum of 2 minutes, no more often than

Once per week. But done with very slow movements at high intensity. That is 10 minutes of work in about 15 minutes in a gym once a week. With very powerful results. Worth it!

[middlejoel in reply to MateoBeach]

My daugher is a gym rat, she loves it. Over the years, she has bought me weights and stretch bands. I have tried a regime using low 5-10 pound weights a few times. Didn't last, not my thing. I can't see myself doing high intensity, thanks for the suggestion.

[MateoBeach]

High intensity is not the same as heavy weights. The Big 5 are doing exactly as promised for me and I am very pleased. Read the book. It specifically recommends using 5 well designed gym machines for the 5 exercises to avoid injury. No free squats nor dead lifts, just seated, back supported leg presses for entire lower body. Weight well below max. But with the very slow reps under constant load it is very intense and fatigues all muscle fibers maximally within 90 seconds up to 2 minutes. Done. No second set. Don’t come back for a week until muscles completely recovered. 5 safe exercises, 2 minutes each. Get instruction on the machines at the gym, but use the mechanics he describes in the book (actually easier on the joints than the standard methods).