How having strong muscles decreases risk of Chronic Disease
A large systematic review and meta-analysis examining nearly 40,000 patients with chronic diseases (including cancer, cardiovascular disease, COPD, chronic kidney disease, and metabolic disorders) found a strong inverse relationship between muscular strength and mortality.
What the research shows
For every 5 kg increase in strength, the risk of all-cause mortality dropped by around 25–30% — a dose-response relationship that strengthens the case for causality.
Patients with low muscular strength had an approximately 80% higher risk of death compared to those with higher strength.
These associations remained independent of age, sex, disease severity, BMI, and cardiorespiratory fitness.
Muscle is a metabolically active organ that plays a central role in survival:
1. Metabolic regulation Skeletal muscle is the primary site for glucose disposal. Greater muscle mass and strength improve insulin sensitivity and glycaemic control, which is critical in conditions like type 2 diabetes, cardiovascular disease, and metabolic syndrome.
2. Anti-inflammatory effects Chronic disease is often accompanied by persistent low-grade inflammation. Contracting muscle releases myokines that help regulate immune function and reduce systemic inflammation — a key driver of disease progression.
3. Protection against functional decline Loss of strength accelerates frailty, disability, and dependence. Stronger patients maintain mobility, balance, and independence longer, reducing complications such as falls, hospitalisation, and institutionalisation — all of which increase mortality risk.
4. Greater resilience during illness and treatment Patients with higher strength tolerate medical treatments (including surgery, chemotherapy, and hospitalisation) better, recover faster, and experience fewer adverse outcomes.
Traditionally, chronic disease management focuses heavily on:
medications
symptom control
aerobic fitness
body weight
But the evidence shows that muscle strength is a missing vital sign. Low strength is not just a consequence of disease but it is a modifiable risk factor that actively contributes to worse outcomes if left unaddressed.
Even after a diagnosis of chronic illness, getting stronger can still meaningfully improve survival odds. Strength training is not “optional” or “extra” in chronic disease care it is: Preventative, protective and therapeutic. And importantly, it works at any age and any starting level.