Useful Health Finds

Being weak and less fit cardiovascularly is NOT good for longevity

My wife forwarded me an IG post of Dr. Peter Attia citing how different factors increase mortality rates:

• Hypertension: +20%

• Diabetes: +30%

• Smoking: +50%

• Being weak (vs. strong): +250%

• Having a low VO₂ max (bottom 25%): +400%

When I first saw that, I was blown away. I’ve always known strength and cardiovascular fitness are major drivers of longevity, but those percentages looked huge—so I dug into where they came from.

Here's the post.

The VO₂ max data (Mandsager et al., 2018)

The “low VO₂ max” stat tracks directly to hazard ratio ≈ 5.0 in the Mandsager 2018 JAMA Network Open study—meaning the least-fit group was five times more likely to die than the most-fit.

• Being in the top 2.5 % (elite) was associated with an ≈ 80 % lower mortality rate.

• The “above-average” group (50th–74th percentile) still had a ~39–47 % lower risk.

Takeaway: every step up in fitness helps; even “above average” fitness confers major protection.

If you’re using an Apple Watch or similar tracker, aim for:

• ≥ 40 mL/kg/min → Good fitness

• ≥ 43 mL/kg/min → Very good fitness

Both levels align with that “above-average” band from the study.

Strength and muscle

The “+250 % mortality” figure comes from meta-analyses comparing the weakest to the strongest quartile.Technically that’s about 2.5× the risk (HR ≈ 2.5)—so roughly a 150 % increase, but Attia and others round it to “250 %.”

Regardless, the pattern is clear: stronger people live longer. Here’s a quick summary from pooled studies:

Relative change	Typical percentile move	Approx. HR	Mortality change
+10 % stronger	one quintile higher	0.9–0.95	5–10 % lower risk
+30–40 % stronger	bottom → top quartile	0.5–0.7	30–50 % lower risk
+50 % stronger / restored normal muscle	sarcopenic → normal	0.35–0.5	50–65 % lower risk

At EverStrongSF, clients commonly see 30–100 % strength increases, depending on movement—exactly the range that research links to large drops in mortality risk.

Maybe not creatine gummies?

Creatine has great evidence behind it, but gummy forms can degrade or under-dose over shelf life. SuppCo’s lab testing found many gummies contained little or no active creatine. Stick with creatine monohydrate powder—I use Momentous.

Unsafe lead in protein powders

I used to recommend Orgain Double Chocolate mainly for taste, but Consumer Reports now lists it under “consume less frequently” due to lead content. In August I switched to Transparent Labs, which rated in the safe to consume frequently category. Worth checking the list yourself.

A good NYT piece on strength training

The NYT is spot on. It hits every EverStrongSF principle:

• Build muscle in midlife – we do this daily.

• Slow the clock – see above.

• Lift beyond your comfort zone – exactly what we coach.

• Eat protein + carbs – at least 0.5 g protein / lb ideal bodyweight.

• Don’t rush recovery – fast-twitch fibers can need 4–10 days.

Bottom line

Improving fitness—both strength and VO₂ max—delivers some of the largest, best-documented reductions in mortality risk known to science.You don’t need to be an elite athlete—just get above average and keep progressing.

Abe