“If you can do 41 push-ups, you don’t have to worry about dying of a heart attack!”
Such are the headlines that have been making mainstream news, suggesting that there is a relationship between cardiovascular disease (CVD) and – seriously – push-ups. This theory seems a little far-fetched, but consider that the basis of these headlines can be traced to a study from Harvard Medical School that involved more than 1,000 subjects over 10 years.
Were our gym teachers and military drill sergeants who told us, “Drop and give me 10!” giving us teachable moments on how to live long and prosper? Are pumpable pecs and horseshoe triceps the key to clear arteries and low cholesterol? Short answer: “No!” Long answer: “You can’t be serious -- heck no!”
Let’s take a closer look at this push-up proficiency propaganda, starting with why this research has captured our attention.
According to the American Heart Association (AHA), an estimated 1-in-3 deaths each year, or 2,300 deaths per day, are attributed to heart disease in the US. Multiply the cost of Trump’s Great Wall by eight, and that’s how much heart disease costs each year in the US!
Among the key factors the AHA says are associated with CVD are smoking, physical inactivity, nutrition, overweight/obesity, cholesterol, diabetes, and high blood pressure. Other medical think tanks, such as the National Institutes of Health, agree that a lack of exercise is a cardiovascular risk factor. This is troubling because an estimated one-third of adults in the US don’t exercise.
The reason this push-up study has drawn so much attention is that muscle strength is usually not singled out as an independent variable in CVD. In fact, diet and aerobic training celebrity Covert Bailey (of “Fit or Fat” fame) published a best-selling book called “Smart Exercise,” implying that aerobics was “smart” and weight training was, obviously, “dumb!” There was even one doctor who said those who can run a marathon don’t have to worry about dying of a heart attack, a statement that unfortunately didn’t hold true as many runners have died while trying to complete this grueling race. Just sayin’.
Back to the Harvard study, it was published in the February 2019 issue of the Journal of the American Medical Association Network Open. Just Google, “Association Between Push-up Exercise Capacity and Future Cardiovascular Events Among Active Adult Men,” and you can download a free PDF of the entire study. But before going further, consider that “cardiovascular disease” is a collective term relating to diseases of the heart or blood vessels that can result in conditions such as chest pain, arrhythmia, stroke, and yes, heart attacks.
The study involved observing the cardiovascular health of 1104 firefighters over 10 years. It actually started with 1562 subject, but about a fourth of them did not show up for the follow-up – their loss! The remaining subjects, who had no job restrictions at the start of the study, participated in baseline assessments that included performing as many push-ups as possible. The subjects were divided into one of five categories based on their push-up performance: Category 1, 0-10; Category 2, 11-20; Category 3, 21-30; Category 4, 31-40; Category 5, 40+.
The results? “Participants able to complete more than 40 push-ups had a 96% reduction in incident CVD events compared with those completing fewer than 10 push-ups,” said the authors. Wow – Stop the presses! This conclusion obviously leads to the following recommendation by the authors: “Push-up capacity is a no-cost, fast, and simple measure that may be a useful and objective clinical assessment tool for evaluating functional capacity and cardiovascular disease risk.” That’s their side, now let’s talk about what when wrong with this research.
First, the study involved primarily healthy, middle-aged, active men – they were, in fact, firefighters. As such, the results may not apply to women or men who are older or sedentary. Next, body type can influence push-up performance. A slender guy with low body fat may have an advantage in push-up potential compared to a large man who is overweight. It’s also likely that the slender guy is already at a much lower risk of CVD because of their lower bodyfat. This begs the question: “Is the ability to perform push-ups a characteristic of good health, or is practicing push-ups to get better at push-ups the cause of good health? So much for speculation – let’s break down the data.
First, you’ll find that there is not a linear relationship between push-up performance and the rate of CVD. For example, the study found that those subjects who did 31-40 push-ups reported 433 incidences of CVD, but those who did 21-30 only reported 288 incidences! If you struggle with push-ups and your day planner is so packed that you can only devote one minute a day to exercise, maybe you should stop at 30 push-ups so you don’t risk ending up in the dreaded Category 4!
Another puzzling piece of data from the study is the effects of aerobic fitness (as measured by V02max, mLkg per min -- such that the bigger the number, the better the fitness) on CVD. Once again, there were five fact-finding categories. The groups that scored 36-42 on this cardio test reported 385 incidences of CVD and the group that scored 43-49 did better with 327. But those fitness buffs who worked themselves into a 50-56 level score suffered 641 incidences of CVD! Holy crap on a cracker! Is the takeaway here to stop, maybe, at 14 minutes a day on the treadmill so you don’t get too fit and need a pacemaker? Wait, there’s more -- let’s not forget about smoking!
The Category 3 subjects in this study included 102 former smokers and 58 current smokers, but the apparently less healthy Category 4 subjects had only 64 former smokers and 24 current smokers. Huh? Is the message here that if you want to lower your risk of pulmonary peril, you should consider adding a cigarette to your post-workout supplement program!
Finally, if you’re really into stats, you’ll have fun figuring out how age factors into this push-up proficiency prescription. In the follow-up study, those who performed 41 or more push-ups had a mean age of 35.1. Those who completed just 0-10 push-ups had an average age of 48.4! Hmmmm…that adds up to 13.4 years. Without reviewing any research, doesn’t it seem reasonable to assume that a 48-year-old might have fewer visits to their cardiologist than a 35-year-old?
There is considerable research about the health benefits of resistance training, and certainly the push-up is one practical form of resistance training assessable to all. But if you think that a few dozen push-ups a day (well, specifically, 41 or more) is the secret to longevity, think again.