Grip, Mortality, Goodhart & Ozempic
There has been a lot of talk on accounts I follow surrounding a relatively recent study correlating grip strength with a reduction in all-cause mortality.
Naturally the social media synthesis of this has made grip strength the new zone 2, the one thing you need to focus on to live a long and healthy life; and yet that doesn't seem quite right does it?
Goodhart's Law: When a measure becomes a target, it ceases to be a good measure.
I have no doubt that the correlated data shows the pattern, but the analysis misses the point. What it says to me is that any activity that improves grip strength as a byproduct is to be pursued, not that grip strength should be pursued as an end in itself.
The individual that lifts weights, rock climbs, or develops gymnastics strength is more likely to have a better quality of life than the one that buys a grip strengthener. One optimises general capacity, the other optimises specific capacity.
The individual that lowers their cholesterol by making sensible adjustments to their diet and engaging in a well rounded training program will experience better long term outcomes than the one that uses statins. One optimises for the cause, the other for the symptoms.
The individual that adds a broad range of fruits and vegetables to their diet will see better outcomes than the one that takes a fibre supplement. One optimises for general nutrient density, the other for specific fibre amount, stripped of the related vitamins and minerals.
In each of these examples the short term fix is better than nothing, and can bridge a gap in motivation or knowledge.
The most relevant and recent phenomenon of this is the public discourse around GLP-1 agonists, more colloquially known as Ozempic or Mounjaro. Anybody that has attempted weight loss knows that appearance and scale weight are lagging indicators, taking time to bear fruit while the evolutionary hardwiring of increasing hunger builds pressure, leaving most weight loss attempts unsuccessful within the first few weeks, precisely when the results are about to show. These new drugs bridge the gap between effort and result, curbing the hunger response and allowing access to progress for many people for the first time.
The long-term implications are unknown but can be predicted from our understanding of nutrition in general. Long term calorie deficits are not good for health, leading to deficiencies in bone density, muscle mass, vitamins & minerals. Blunting hunger doesn't circumvent the body's need for nutrients.
In addition temporary weight loss strategies (8 week challenges and the like) frequently see weight regain once the diet period is over. This is a widely reported outcome emerging in the use of these drugs, the hunger returns (often in extremis).
Exercise, with all its signalling properties for productive use of nutrients and development of muscle mass, and nutritional education to establish what and how much needs to be consumed for health and the support of activity, are both essential. Without them anybody using these drugs will fall into the same traps as have always been laid in the wellness industry: quick results at the expense of long term knowledge, dependency on a product in lieu of agency and autonomy.
This is not to say GLP-1 agonists are bad. If an intervention can help somebody achieve a goal then it's worthy of consideration. The value judgements around discipline, effort and motivation frequently miss the point, namely that motivation is often seen as a spark that sets off action but is better understood as momentum that is more likely to build once work starts to bear fruit.
To return to Goodhart's law: If weight loss is the sole target, the intervention is effective, however, if the goal is a long term strategy of nourishment then it ought to be one tool among many.
