Hey, everyone, welcome to another edition of Wisdom Wednesdays.

Today's session, I am going to try to convince you to update your present list for Santa and stick a hand grip.

Dynamometer on there.

Now, you will have heard me talk before about strength training and muscle mass is critical to aging well.

But today I want to talk about a really fascinating study that's just been published that really brings this point home and gives us a tool that is so simple, so cheap, and so powerful that it really should be in every gpage toolkit.

Every time you go to the doctor, they should be measuring this, just like they measure your blood pressure.

So the research paper in question has just been published in the American Journal of Preventative Cardiology and the title of the paper is Grip Strength to Weight Ratio all Cause and Cardiovascular mortality and Cardiovascular disease prevent Prevalence evidence from n Ham's and Charles.

So what they did in this study was they looked at something called grip strength to weight ratio or GSWRS I will refer to it.

And obviously it's a relationship with all cause mortality, cardiovascular death, and the prevalence of cardiovascular disease.

Now, we've known for a while that grip strength is a useful biomarker, and I've talked about this before.

It's been linked to everything from frailty prediction and falls, to heart disease, depression, and even a very strong linked to dementia.

But absolute grip strength, like many things in health, isn't the full story.

Because bigger people tend to have higher grip strength, but does that mean that they're healthier?

Will not always.

And what the researchers did in this study, which I loved, was they normalized grip strength to body weight to get a more individualized, more meaningful metric which they call GSWR grip strength to weight ratio, and that is basically how strong you are for your size, and that is a much better predictive value for an individual on an individual basis.

So let's dive into the study.

And what they did was they analyzed data from these two massive nationally representative cohorts and the US Enhange Study and the Chinese Charles Study, And between the two, we're talking over twenty thousand individuals that were followed for seven or eight years, and that's a pretty strong data set and Obviously they were older individuals because they were looking at things like cardiovascular these and all cause mortality.

Now, strength was measured with a hand gripped dynamometer and you can actually buy them, and we bought one in our house about a year ago and a bit where we're using it.

You can buy one in.

Australia on Amazon for twenty nine Australian dollars.

In the States have checked it up, you can buy one for nineteen US dollars and in the United Kingdom that come as cheap as seventeen quid.

Right, And here's how to replicate what they did in the study.

You get this dynamometer, which is basically something that you squeeze and it measures your force that you produce.

Typically in kilos.

And what you do is you stand upright and firmly grasping the dynamometer with your elbow flex at ninety degrees, so your kind of forearms sticking out from your body, and then you squeeze the dynamometer as hard as you possibly can for three to five seconds.

And what it will do is will record the max force that you can produce, and typically it gives it in kilos.

I'm not sure if the US ones do it in pounds.

If it's pounds, then you just use that because it's normalized.

And what you do is you do it twice for each hand, rest for thirty seconds in between, or you could probably just go to the other hand and then back and you get two two values reach one and you pick the best of each hand.

So you pick the best for your right and the best for your left.

And then you add them up.

So say you were to get ninety kilos from your left and eighty five for your right hand, you'd add them up and that's one hundred and seventy five kilos, and then you divide that by your body weight.

Now again in the United States, if it's measuring it in pounds, that's fine.

You just add up the total pounds in this case would be about one hundred and eighty hundred and ninety ish on each hand.

You add that up and then you divide it by your body weight, and again your bodyweight.

Will be in kilos.

Or if you're doing the American one and they give you the dynamoma in pounds, then you use your body weighing pounds.

Now let's get.

Back to the study and what they did was they tracked deaths all cause mortality, deaths from anything, and death from cardiovascular disease, and they also assessed cardiovascular disease prevalence using medical history.

They used interviews in national mortality records, and then they adjusted for all the usual suspects.

So this is important because these were adjusted for things such as your age, your sex, your body mass index, hypertension, diabetes, smoking, blood lipids, socioeconomic statius.

They did that lot and.

The results were seriously compelling compared to people.

And what they did is they separated them into quartiles, so the lowest twenty five percent, then the low medium, the high medium, and then the highest twenty five percent.

Compared to people in the lowest quartile, so the lowest twenty five percent of the weakest twenty five percent.

Those in the highest quartile had a seventy three percent lower risk of dying from any cause in the US cohort and a forty seven percent lower risk of dying in the Chinese cohort, and cardiovascular deaths were also dramatically lower in the US cohort.

The strongest twenty five percent had a seventy nine percent risk reduction for cardiovascular deaths, right, and that is pretty bunkers.

So I'll give you the cutoffs.

Let's just look at the end he hits cohort, So the lowest quartile.

Q one, when you do then hazard ratios for mortality.

And the Q two so twenty five to fifty percent in terms of strength, so low the medium.

Their hazard ratio compared to Q one was not zero point four to seven, so they had a fifty three percent reduced all cause mortality than weaker So just going from the weakest to the second weakest group reduced your risk of all cause mortality by whopping fifty three percent, Like that is bunkers.

And Q three, which are those people sort of fifty to seventy five percent, so they're above average.

Their hazard ratio was zero point three nine, so basically they're sixty one percent less likely to die of anything than the weakest group.

And as I said, Q four their hazard ratio was zero point twenty seven, so they had a seventy three percent lower risk of all cause mortality compared to the weakest groups.

And that this is just completely and ulterly bunkers in terms of the impact.

And when we look at the China study, and there the Q four the strongest group.

Their hazard ratio was zero point five, so they are are forty seven percent lower risk of death and everything.

Why the difference in the Canadian A sorry, in the Chinese versus the US, Probably because the US population on the whole are on the healthier because that they got a higher risk of dying and therefore and that strength was more protective.

But just taking these things together and this is really impactful and importantly, the researchers observed a classic L shape relationship, meaning the biggest benefits come from getting out of the lowest twenty five percent.

In other words, you don't need.

To be a gym bunny, you just got to be stronger than the weakest twenty five percent.

Personally, I think this is huge implications for our exercise guidelines.

So if you take the data from Australia, the most recent data showed that only twenty percent of Australian adults hit the recommended guidelines for physical activity when it comes to strength training, particularly in.

Older age groups.

Right, so only one in five are doing the recommended two strength training sessions a week.

About sixty percent actually hit the baseline of one hundred and fifty minutes of moderate physical activity a week, you know, so there's reasonable amount who do that, but only one in five or twenty percent actually do the strength training stuff.

And this should be a massive, massive wake up call.

I mean, here's the thing.

If you have a job that involves manual labor, you know, your grip strength is probably fine, in fact, it's probably very good.

But if you do an office job and you're not in the gym lifting heavy shit, the chances are that you are in one of those lower two quartiles, and it's more important that you do strength training.

That is really important call to action here for this, So I'm a big fan.

Just get a basic grip dynamometer online.

As I said, it's going to cost you twenty to thirty bucks depending on where you are.

Measure your grip from each hand, add them together and then divide that by your body weight.

Right, So again it will give you your grip strength and kilos.

So you divide it in kilos and that is your GSWR.

So I'm having sure my value.

So my right hand was buying on fifty kilos, my left hand was forty six point nine kilos, so that gives me a combined force in the two hands of ninety six point nine kilos divided by my body weight, which is eighty gives me a GSWR of one point two to one.

So if you're doing any type of strength training at all, you're likely to be above one in terms of that cutoff.

And in in our house, everybody is above the cutoff for Q four.

So Q four is not zero point nine two or above right ninety two percent of your body weight combined hands, you are in the top quartile and are very very protective.

Unfortunately, the research paper didn't give us all of those cutoffs, but I went in and looked at it and approximated it.

So they do these curves.

If you read the research paper, you can kind of work it out from the graphs.

So what I've worked out is is the Q four, which they did say that was above zero point nine two Q three is not point eighty eight to not point nine.

Two Q two.

So this is where you're starting to get a little bit into trouble.

That was not point eight three to not point eighty eight.

And in Q one, the weakest group, we're not point eight three.

So if your combined force from their left in your right hand is less than zero point eight three.

I would suggest that the most important thing you need to do for your healthy get yourself into the gym and start lifting heavy shit.

Now that's the data from the En Haynes quote.

That's the American one.

I didn't actually do the data for the Chinese one, but I think that's that's probably good enough for everybody as a target to go.

And this metric is so powerful and so predictive and so easy to measure that I think that it should be in every single doctor surgery and they should do this in routine checkups.

I mean, you come in, they'll do your blood pressure, some of them do your weight, and let's do your comparison here, right, So blood pressure, Yes, we know that elevator blood pressure increases the risk of stroke and heart disease, but on its own, it's actually quite a poor predictor of all cause mortality, and it can be quite variable.

Then fasting glucose or even he HbA one C.

They are strong predictors of diabetes risk, but again, many people live in a gray zone for years, and they're not actually very strong predictors of all cause mortality, and certainly not as strong as this script.

Strength LDL cholesterol with many are obsessed with, has been associated with cardiovascular risk, but half the people who have a heart attack have normal LDL.

And it's a really shit house predictor of all cause mortality, particularly in older adults and in body mass index, which you know we've been obsessed with for decades.

Don't even get me started on that shit.

It is such a blunt tool and such a poor predictor of cardiovascars, the's mortality and all cause mortality.

Now, compare that to grip strength.

So we talked about it in this paper, but I'm going to give you some other evidence, right, so this is not just a one off.

A twenty eighteen study in a British medical journal found that grip strength was a better predictor of all cause mortality than systolic blood pressure.

Another study in the Lancet called the Pure Study showed that grip strength was a strong predictor of cardiovascular mortality than blood pressure or even physical activity.

So why isn't it standard in every clinic?

I guess that's the question.

But strength training is clear that it matters, and it matters more than we used to think.

Now, if your GSWR isn't where you want it to be.

Don't panic, but you do need to act.

And it's not about just hanging off a bar to improve your grip strength.

Really, grip strength is a proxy for engaging in strength training.

People who have high grip strength either have done lots of strength training or they do lots of physical labor, so they're using their muscles.

And there is a mountain of data that supports the idea that good muscle strength is a really good predictor of not just how long you're going to live, but also quality of life as well.

I've written extensively about this in my latest book, The Hardiness Effect, and I've also talked about it on a couple of different podcasts.

But what we know, for instance, a twenty seventeen study in the Journals of Gerontology so that muscle strength is a stronger predictor of longevity than muscle mass.

So it's not about big muscles, it's about how strong they are.

And then another meta analysis published in the European Journal of Preventive Cardiology in twenty twenty two found that people with higher muscle strength out of thirty one percent lower risk of all cause mortality compared to those.

With the lowest levels.

Right now, in this study it was it was significantly bigger than that.

But when you see more and more evidence, are different papers with results that are in a similar direction, then we start to say, hey, this evidence is really really strong and strength training.

The benefits of strength training are more pronounced in older adults.

That leads to better functional mobility, fewer falls, less realty, better glucose control, low inflammation, and of course better grip strength.

So the big take up here is buy a hand grip dynamometer.

They are very cheap, you can get them on Amazon.

Measure your grip strength and calculate your GSWR.

Then compare it to the data that I talked about earlier on If you're in the lowest quarter earlier that you're even Q two, commit to change and start strength training twice a week.

We've shown that adults who engage in strength training twice a week significantly improve their strength, particularly older adults.

In a world where we have warribles that track everything and give us all of these different fancy diagnostics, sometimes the simplest tools are the most powerful.

So grab a grip strength meter, pick up some weights and take control of a metric that might just save your life or it certainly will extend it and improve the quality of your life.

That's it for this week, folks, Catch you next time.