• Dr. Ragnar

Lift Stuff: Add Mass To Your Body And Years To Your Life

This article was initially published in Breaking Muscle as the fourth installment of a 5-part series: https://breakingmuscle.com/fitness/lift-stuff-add-mass-to-your-body-and-years-to-your-life

“Strong people are harder to kill than weak people, and more useful in general.”  The infamous words of Mark Rippetoe are often used to drive the avid gym-goer to squat more, deadlift more, and bench press more. But when your goal is health and longevity, the quote takes on an even broader meaning. Using The Great Upside-Down Movement Pyramid, we’ve ticked off a number of health risk factors by sitting less and walking moreBut if you want to be independent, disease-free, and alive for as long as possible, it’s time to start moving stuff.

Critical Mass

While health professionals and the media regularly talk about the threat of cancer, type-2 diabetes, and heart disease, not many people talk about the risk of low muscle mass. As we age, even if our weight stays the same, we start losing muscle mass and gaining extra “padding” to compensate [1]. The best way to prevent that? Lifting stuff [2].

Muscle does more than just help you fill out a t-shirt and make it harder to buy a pair of jeans that fits. We now know muscles make up the largest organ in the body [3]. In response to movement, muscles secrete a number of factors that reduce inflammation, improve bone health, and help protect against heart disease and multiple forms of cancer [3]. Adding muscle through resistance training is also one of the most reliable ways to improve insulin sensitivity and metabolic health [3,4].

"Making sure you get some of that muscle back is going to be crucial for future health. This doesn’t mean you need to take up bodybuilding. You just need to make sure you’re above average."

Focusing on muscle mass is particularly important for those who have engaged in active weight loss, as both higher body fat and a calorie deficit can lead to a loss in muscle [5,6]. In the general population, people with more muscle mass live longer, so making sure you get some of that muscle back is going to be crucial for future health. This doesn’t mean you need to take up bodybuilding. You just need to make sure you’re above average [7]. But unless you have a debilitating disease, I’m afraid there isn’t a pill for that [8].

In summary: Better start those bicep curls now…

Everybody Get Up

Maybe even more important than muscle mass is muscle strength. As we age, we lose strength even faster than we lose the muscles themselves, and muscle strength is directly related to our ability to remain mobile and independent as we get older [9,11]. So if you want to make sure you’re around to spend as much of your children’s inheritance as possible, and it’s been a while since you thought about your strength and balance, then now is the time to start working on it again. Try this:

  1. Sit down on the floor and then get back up. Easy.

  2. Now try it without using your arms or hands for support, or resting your knees on the ground at any point. Not so easy.

  3. Now imagine that you start the whole movement with ten points. Subtract a point every time you need to support yourself with your arms, touch your knee to the ground, or become unbalanced. The lower your final score is, the greater your risk of mortality (death) [12,13].

In one move, this simple test examines leg strength and balance, which have repeatedly been shown to predict risk of death by any cause.7 Stronger people really are harder to kill.

In summary: Want to improve strength and balance and live longer? Lift stuff [14-17].

Burpees Will Save Your Life

While the thought of getting stronger is all well and good, let’s face it: in the modern world, strength is optional. As humans, we’ve crafted our environment to make life easy. While that’s helped us get where we are today, it comes at a potential price.

What happens when there’s nobody there to help you?

Every year in the UK, 65,000 people fracture a hip, usually after a fall [18,19] In the US, the number is nearly 300,000 per year [20,21]. After fracturing a hip, almost a third of people will die within a year, and less than half of the survivors will regain complete independence [22].

 "If you’re strong enough to do a burpee, not only will you will be less likely to fall, you’re also more likely to get yourself up if you do fall."

Sound a bit dramatic? Then consider the fact that 30-40% of people over the age of 65 will have at least one fall per year, and more than 20% of women and 10% of men are predicted to fracture a hip in their lifetime [23]. Even if you don’t break anything, up to 50% of people that fall are unable to get up unassisted, and will often need hospitalization by the time help eventually arrives [14].

Want to make sure you avoid that? All you would need to do is be able to push yourself up off the floor and lunge/squat yourself upright. If you can do those movements (a push up and a squat), you can do a burpee. And if you’re strong enough to do a burpee, not only will you will be less likely to fall, you’re also more likely to get yourself up if you do fall.

In summary: Strength is optional, until it isn’t any more. And burpees will save your life.

Find Failure

When it comes to lifting for strength and muscle mass, everyone has their favorite method and training structure. However, whether you prefer free weights, machines, or bodyweight exercises, the evidence to pick one over the other isn’t that compelling [24]. The upshot of this is that you can pretty much do whatever you enjoy and are most comfortable with.

However, for general increases in strength and health, a few guidelines will help you get the most out of lifting things:


To get the best metabolic, muscle, and strength-building effects, you need to activate as many of your muscle fibers as possible, and this requires maximum intensity [25,26]. The simplest way to do this is to make sure you reach failure (i.e., are unable to do another rep with good form) at the end of the set [24]. In fact, a single set to muscular failure is probably all you need in order to get significant strength and muscle gains, and even improve cardiovascular fitness [24,27,28].

How much?

The best balance of benefits will come from sets where failure is reached in 6-12 reps [24,26]. This will remain the same whether you can only do bodyweight squats, or can squat 250kg for 10 reps. After an adequate warm-up, work with weights above 80% of your one-rep max (1RM), because this will put you in the right range for high intensity over 6-12 reps, but also give other benefits, like making your bones stronger [29].

What movements?

While burpees will get you pretty far, the best results will come from improving strength in every direction. Dan John* would boil this down to five main movement patterns:

  • Push (bench press, shoulder press, push ups, dips etc)

  • Pull (pull-ups and rows)

  • Hinge (picking stuff up)

  • Squat (squatting)

  • Carries (carrying stuff, like farmer’s walks or shopping bags)

How often?

For the movement-averse, doing a single set to failure in each of those movement categories once a week is enough to see significant benefits [24,26-28]. However, what we really want is to make movement a habit that’s built into our day. A better aim would be to hit 50-100 repetitions of each movement pattern at the desired intensity per week. The more frequently you lift, the less total volume you can use to see more total benefit [30].

In summary: For optimal gains - fail a little bit, and often.

*Don’t know who Dan John is? Open a new browser tab right away. Read some of his stuff, and then come back. I’ll wait…

Be Harder to Kill

Skipped to the end? Here’s what you need to know:

Optimal health and longevity hinge on your ability to pull your socks up, and push yourself to get stronger, with benefits that will carry over to multiple other areas of your life. And you should squat more.


1. Zamboni et al.. Health consequences of obesity in the elderly: a review of four unresolved questions. Int J Obes (Lond). 2005 Sep;29(9):1011-29.

2. Mekary et al.. Weight training, aerobic physical activities, and long-term waist circumference change in men. Obesity (Silver Spring). 2015 Feb;23(2):461-7.

3. Pedersen and Febbraio. Muscles, exercise and obesity: skeletal muscle as a secretory organ. Nat Rev Endocrinol. 2012 Apr 3;8(8):457-65.

4. Miller et al.. Effect of strength training on glucose tolerance and post-glucose insulin response. Med Sci Sports Exerc. 1984 Dec;16(6):539-43.

5. Wannamethee and Atkins. Muscle loss and obesity: the health implications of sarcopenia and sarcopenic obesity. Proc Nutr Soc. 2015 Apr 27:1-8.

6. Heymsfield et al.. Weight loss composition is one-fourth fat-free mass: a critical review and critique of this widely cited rule. Obes Rev. 2014 Apr;15(4):310-21.

7. Srikanthan and Karlamangla. Muscle mass index as a predictor of longevity in older adults. Am J Med. 2014 Jun;127(6):547-53.

8. Sepulveda et al.. Pharmacology of manipulating lean body mass. Clin Exp Pharmacol Physiol. 2015 Jan;42(1):1-13.

9. Clark and Manini. What is dynapenia? Nutrition. 2012 May;28(5):495-503.

10. Visser et al.. Muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons. J Gerontol A Biol Sci Med Sci. 2005 Mar;60(3):324-33.

11. Hasselgren et al.. Is leg muscle strength correlated with functional balance and mobility among inpatients in geriatric rehabilitation? Arch Gerontol Geriatr. 2011 May-Jun;52(3):e220-5.

12. Brito et al.. Ability to sit and rise from the floor as a predictor of all-cause mortality. Eur J Prev Cardiol. 2014 Jul;21(7):892-8.

13. Instructional video: [https://www.youtube.com/watch?v=MCQ2WA2T2oA]

14. Tinetti et al.. Predictors and prognosis of inability to get up after falls among elderly persons. JAMA. 1993 Jan 6;269(1):65-70.

15. Hasselgren et al.. Is leg muscle strength correlated with functional balance and mobility among inpatients in geriatric rehabilitation? Arch Gerontol Geriatr. 2011 May-Jun;52(3):e220-5.

16. Lee et al.. Global muscle strength but not grip strength predicts mortality and length of stay in a general population in a surgical intensive care unit.Phys Ther. 2012 Dec;92(12):1546-55.

17. Newman et al.. Strength, but not muscle mass, is associated with mortality in the health, aging and body composition study cohort. J Gerontol A Biol Sci Med Sci. 2006 Jan;61(1):72-7.

18. National Hip Fracture Database Annual Report, 2015. 

19. Ambrose et al.. Falls and Fractures: A systematic approach to screening and prevention. Maturitas. 2015 Sep;82(1):85-93.

20. Brauer et al.. Incidence and mortality of hip fractures in the United States. JAMA. 2009 Oct 14;302(14):1573-9.

21. Stevens and Anne Rudd. Declining hip fracture rates in the United States. Age Ageing. 2010 Jul;39(4):500-3.

22. Morrison et al.. The medical consultant's role in caring for patients with hip fracture. Ann Intern Med. 1998 Jun 15;128(12 Pt 1):1010-20.

23. Oden et al.. Lifetime risk of hip fractures is underestimated. Osteoporos Int. 1998;8(6):599-603.

24. Fisher et al.. Evidence-based resistance training recommendations. Med Sport 15 (3): 147-162, 2011

25. Carpinelli. The size principle and a critical analysis of the un- substantiated heavier-is-better recommendation for resistance training. J Exerc Sci Fit.2008; 6:67Y82.

26. Schoenfeld. The Mechanisms of Muscle Hypertrophy and their application to resistance training. J Strength Cond Res, 2010; 24(10): 2857-2872

27. Phillips and Winett. Uncomplicated resistance training and health-related outcomes: evidence for a public health mandate. Curr Sports Med Rep. 2010 Jul-Aug;9(4):208-13.

28. Steele et al.. Resistance Training to Momentary Muscular Failure Improves Cardiovascular Fitness in Humans: A Review of Acute Physiological responses and Chronic Adaptations. J Exerc Phys, 2012; 15: 53-80

29. Vincent and Braith. Resistance exercise and the bone turnover in elderly men and women. Med Sci Sports Exerc 2002; 34: 17-23.

30. Hoffman et al.. The effect of self-selection for frequency of training in a winter conditioning program for football. J Strength Cond Res 1990; 3: 76-82.

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