Pushups and Risk of Death

References: JAMA Feb 2019, JAMA 1999, NEJM, 

Did this ever make the news! "How many pushups you can do predicts your risk of future heart disease." I promptly read every word and sat there worrying. Goodness, I haven't done a pushup in a long time. I can walk 5 miles. I can shovel mulch. I can carry my 25 pound French Bulldog a mile home when the ice hurts her feet. Can I do pushups? I plopped down on the floor and managed 4. Hmmm.

So I read the article in a bit more detail. Who was the population? There were 1562 firefighters examined at one clinic for their physical fitness. Their mean age was 39. Their mean BMI was 28 (so they weren't exactly trim). But they were firefighters. All male. All expected to be fit in order to do the things firefighters need to do. 
What was their risk? Well, of those 1562 men, there were 47 heart attacks over the next 10 years. Doing all the statistical magic one does for age and other risk factors, the authors found that the men who could do 21-30 pushups had a statistically valid reduction in heart disease risk, regardless of age. 

So, here we have a functional medical test that only takes 2 minutes to perform, costs nothing and gives us statistically significant results for a population of firefighters. What does it say about older men? Women? Non-firefighters? All unknown. 
Let's peak at the Honolulu Retired Men's Study and Isometric Hand Grip strength as it relates to longevity. Again, men aged 45-64 were followed for 25 years with measurement of their hand grip strength. The findings were pretty interesting. Men with the lowest strength, for their age, by tertile, were dramatically more likely to have the inability to get up without help, walk faster than 0.4 meters per second, or care effectively for themselves. Their conclusion: poor handgrip (arm strength) predicts disability 25 years later.

The Honolulu study had another remarkable finding. Men who walk two miles a day have HALF the mortality of couch potatoes. Get that? Half! Just walking works for older men. Women generally live longer. What does walking do for them? 
Pushups, walking, hand grip are all modifiable. It's all about daily habits and using muscles as part of that.

WWW: What Will Work for Me. Well, well. Did that ever rattle my cage. I've being doing pushups for 10 days now. I was sore for the first three but then, each day, one more. I'm up to 10. I'm old. You can do this too. Women? We don't have data but upper body strength must be on the same range, just different. Want to buy a an isometric hand gripper and do 50 a day. Start.

Pop Quiz

1. The number of pushups you can do predicts YOUR risk of death from heart attack? T or F Answer; Whoa Nellie. This is true for firefighters, in America who are male. It may be true for women, on a different scale. It may be true for older folks, on a different scale. Yet to be determined.
2. What may be a good predictor of future ability/disability? Answer: Hand grip strength. Honolulu Retired men's study
3. These are two measures of what? Answer: overall fitness.
4. IF you are older than an average firefighter, what might you do to keep fit? Answer: walk 2 miles every day. (Get a dog)
5. Does it help to do more exercise? Answer: You bet. And it doesn't have to be all at once. Take stairs. Stand. Pick up sticks in your yard . Walk to get the mail from the mail person so they don't have to carry the package up to your house. Park in the far end of the parking lot from the grocery store. Get up every hour at your desk and do enough squats to get breathing faster. Move.