Forever Strong: A New, Science-Based Strategy for Aging Well

"Gabrielle Lyon is a board-certified family physician who trained in geriatrics. Her basic idea is that skeletal muscle is the key to longevity because most of the diseases of aging are related to deficits of muscle. She flips the script on a common view of the obesity epidemic, arguing that most of us are not suffering from being overly fat but rather under-muscled. As she interprets recent medical research, most people should shift away from working to lose weight and toward working to build muscle—because having more muscle can change the systems of the body in ways that prevent or treat most of the diseases that are killing us. Lyon emphasizes that muscle is an endocrine organ. It’s almost like a built-in pharmacy for the body. So, the more muscle you have, and the more you move it, the more you produce of a certain kind of molecule called myokines, which circulate throughout the body to regulate the workings of almost every organ, including the brain, heart, liver, lungs, pancreas, even bone. Lyon also emphasizes that muscle is a metabolic organ. It is the main site of disposal of glucose in the body. So, more muscle means less type 2 diabetes and less metabolic disease. Most surprising to most people, bigger and stronger muscles also help improve our mental health. Increasing evidence shows that weight training may play a very important role in preventing or slowing the progression of dementia. In addition to providing an accessible overview of some important medical research on muscle, Forever Strong is a practical guide to nutrition for supporting muscle health, especially for people who are lifting weights. The book’s recipes alone are a great reason to read it. Good messaging is not enough to overcome the massive problems of institutional and educational inertia, where strength training is concerned. Physical education classes are being cut from schools. Medical schools teach future doctors little to nothing about exercise. And what they do teach tends to be about aerobics. Health insurance policies don’t pay for exercise physiologists to teach people how to train—even for the treatment of diseases where all evidence shows that exercise is more effective as prevention or treatment than drugs or surgeries. We need a strong movement of people insisting that medicine and society take muscle seriously. We need more people to ask the question you just posed and propose answers to it. To encourage strength training at every stage of life and at every level of education, we need to start with helping adolescents. From junior high school onward, all our kids—not just the ones who play sports—need to have access to the knowledge and practice of strength training. In medical schools, we need exercise to be part of the curriculum for everyone, we need muscle to be a bigger part of the picture in most specialties, and we need exercise-focused questions on the board exams. The biggest opportunities for democratizing strength training lie in the giant untapped market for weight training in medicine, and among older people. Patients who get diagnosed with chronic diseases need to tell their doctors they want exercise to be part of their medical treatment, and insist on getting a prescription for it, in addition to whatever prescriptions for pills the doctors want to give. Every person who moves a parent into a nursing home needs to insist that those institutions have real, robust resistance training equipment on site—because high-intensity strength training is the only thing that can really build muscle and strength for the oldest, frailest people. We could have a program modeled on the Peace Corps or Teach for America that would teach young people to train older people—creating jobs, social connections, and improving health and function all at the same time. But anybody who tries to do any of these things has to be totally clear-eyed about the fact that they are swimming upstream against currents that have gathered force for millennia. That’s what Stronger is all about. Every one of us is caught in the middle of a 2000-year tug of war between medicine and athletics, with doctors on one side and trainers on the other. At stake is who gets to corner the market in what we now call healthcare. In the ancient debates between doctors and trainers about who had the better approach to taking care of the body, physicians often won the argument by pointing to men who were training to build mass as cautionary examples of what can happen if you put athletic training at the center of your life. Ancient doctors said that mass-building could smother a person’s soul and make it impossible to think. The whole tradition of mind-body dualism, which we’ve been talking about, goes back to this white-knuckled conflict between doctors and trainers. And the myth of brain versus brawn—the idea that if you’re bigger, you’re probably also dumber—which so many people still accept as common sense, originated as a rhetorical dirty trick in that conflict. Enough is enough. The best evidence shows that mind and body can’t be separated, and brain and brawn aren’t enemies. As I show in Stronger , the purpose of strength training is much bigger than winning games or getting jacked. Lifting weights and building muscle and strength have existential stakes. Anyone who goes to the gym is training to win a prize so big, it’s hard even to name it. But the prize of lifting weights is life . Strength is the ability to act upon the world in the ways that we want to. What I want is to keep spending time with the people I love for as long as I possibly can. And the way for me to maintain that ability is to show up at the gym, just about every day, and do the best I can do when I’m there and keep an eye out for chances to help others do the same."