一、主要的好處是活命，降低死亡率
可能有些同學會不解，難道人的死亡率不是100%？還有人可以不死？
其實，在相關科學研究中，死亡是有 時間和物件限制 的。比如我們找來100個中年人，追蹤他們15年，15年內有X人死亡，以此計算死亡率。死亡率在很大程度上反映疾病狀況、生存品質和幹預手段的有效性。
2018年的一項大型元分析包含了 37萬多名參與者 ，平均隨訪9年，年齡18-75歲。主要發現包括：長期進行系統阻力訓練可以 降低21%全因死亡率、17%心血管疾病死亡率 ；如果搭配有氧運動進行可降低全因死亡率40%。
支持肌肉/力量與死亡率之間負相關性的證據堆積如山 。
2008年的一項前瞻性佇列研究，對8762名20至80歲男性[67]追蹤了19年之久，發現肌肉力量與各種原因的 死亡和癌癥呈獨立負相關 ，即使調整了其他混雜因素之後也是如此。年齡調整後，肌肉力量和心肺功能水平高的男性，死亡率比肌力水平最低的不健康男性死亡率低60%。並且，肌肉力量升高是長期訓練的結果[68,69]，長期抗阻訓練對死亡率將降低發揮了一定的保護作用。
2007年的流行病學研究調查了800名65歲以上老人[74]，發現握力較高男性死亡風險為低19%、心血管風險低27%、癌癥死亡風險低19%，這些關聯在進一步調整了純肌肉量或體脂水平後仍具有統計學意義。
日本廣島成人健康研究（AHS）佇列研究了35至74歲的4912人[75]，握力每增加5公斤，男性心臟病風險降低15%、中風風險降低10%、肺炎風險降低15%；即使經過20多年的隨訪，每增加5公斤握力仍然降低相對風險8%。
一計畫美國研究包含了2488名65歲及以上的墨西哥裔美國男性和女性[76]，發現在控制了相關的危險因素後，握力是老年墨西哥裔美國人死亡的一個強有力的預測因素，握力<22.01 kg的男性和握力小於14 kg的女性5年後死亡的比例分別為38.2%和41.5%。
對82名老年女性患者的研究發現，最大握力是否達到5KG，是患者存活/死亡的最明確、最敏感分界線[70]；日本的一項對6259人的研究發現，跳躍能力/握力/仰臥起坐能力較低的男性具有面臨較高的死亡風險[71]；
Metter等人在25年中搜集了1071名男性的數據，握力下降與死亡率增加有關[72]；一項對8116人的調查發現，握力/仰臥起坐/伏地挺身等肌肉力量指標可以加拿大人的死亡率[73]；
許多研究選擇握力作為測試方式的原因是，它不需要太多的技巧，簡單易行。如果選擇其他運動來測試，則技巧可能會混淆測試數據。
二、肌肉訓練降低死亡率的其中一種機制：對抗腹部肥胖/代謝症候群
數據表明，人類在25至65歲之間，內臟脂肪可增加 300%以上 [9]。
不同部位脂肪的生理效應截然不同[10]，腹部/內臟脂肪比總脂肪與代謝症候群的關聯性更強、更容易引發健康問題[11,12,24,25,26,27,28,29,30,31,32,33,35,36,37,38,39]。
但如果脂肪分布在下半身或大腿，則相應風險降低[7,8,13,14,15,16,17,18,19,20,21,22,23]。作為印證，女性的雌激素水平比男性更高，由於雌激素具有減少內臟/腹部脂肪（「轉移」到腿臀部）的作用[34]，因此女性的心血管疾病率[34,40,41,42,43]和2型糖尿病機率要低於男性，並且即便兩性的身體脂肪總量大致相等時，也是如此[44,45]。
代謝症候群包含了哪些？
腹部肥胖、血糖/血脂/血壓/低密度脂蛋白膽固醇升高、胰島素抵抗、慢性炎癥，乃至於糖尿病等。並不是胖就完了，代謝症候群其病情發展的終點是各類 致命性疾病 [78,79,80]，包括動脈粥樣硬化[47]、心肌梗死[48,49,52]、冠心病[50,51,53]。
腹部肥胖還促進多種癌癥發病率升高，包括乳癌[81]、結直腸癌[82,90,91,92]、子宮內膜癌[83]、食道癌[86]、腎癌[84]、肺癌[89]、胰臟癌[85]、甲狀腺癌[87]和膽囊癌[88]等。
腰圍越大，各類癌癥機率相應升高。
練肌肉有助於抵抗腹部肥胖和代謝症候群。
因為從原理上說，骨骼肌是人體處理葡萄糖的主要器官[55]，在正常情況下它處理了人體大約80%的葡萄糖[56,57]。
骨骼肌是一個巨大的糖庫，普通人的骨骼肌大概能容納400g左右葡萄糖，或者是每kg肌肉12g左右的糖——如果肌肉量很大，或者長期進行大運動量，肌肉可容納的糖甚至可以超過800g。
註意，葡萄糖一旦被運輸進入骨骼肌，被成肌糖原[122]，就永遠留在裏面了。因為肌肉中沒有相應的酶（葡萄糖-6-磷酸酶），所以肌糖原是無法分解成葡萄糖重新回到血液，不可能再被合成為身體其他部位的脂肪讓我們發胖。
但隨年齡增加身體老化，人類的骨骼肌逐漸萎縮，30歲後每10年萎縮3-8%[1,2]，70歲後每十年就有減少25%-40%[65,66]，這導致靜息代謝率降低、葡萄糖攝取減少、脂質氧化能力降低[6]。
已經證明，肌肉的胰島素敏感性、肌肉攝取/利用/消耗血糖的能力（特別是在不依賴胰島素的情況下），與代謝症候群[58,59,60,61,62]和2型糖尿病[63,64]密切相關。
2007年，美國心臟協會臨床心臟病學委員會和營養、體育和代謝理事會發表了一份科學聲明，參照了一項包括8570名年齡在20-75歲之間的男性進行的研究。
該聲明支持持一切有、無心血管疾病/代謝症候群的人進行肌肉訓練 [93]，因為肌肉力量的發展可能會帶來獨立於心血管健康的、額外的好處；肌肉力量與代謝症候群患病率具有獨立負相關關系。
肌肉訓練與有氧訓練帶來的健康益處出在機制上的相似性，包括減少腹部脂肪[94]、降低血液甘油三酯[95]、降低高密度脂蛋白膽固醇[96]、血糖改善等[97]。
無氧運動/抗阻訓練/高強度訓練都對於減少腹部/內臟脂肪有好處。
Treuth等人觀察到對14名健康老年婦女（平均年齡67歲）進行每周3次持續16周的訓練後，她們的內臟脂肪從143減少到130cm²、同時力量和肌肉橫截面積增加[98]，研究者認為這些變化對於預防與年齡相關的腹部脂肪增加、及由此帶來的負面健康結果可能很重要。
一計畫中國的研究，針對60名65-75歲的肥胖老人，發現單純的力量訓練能減少老人的內臟脂肪，增加他們的肌肉體積、握力[99]。
雖然單純抗阻訓練的減脂效果要低於有氧或混合訓練，但也是不可忽視的一種促進健康的手段。而且力量訓練組的老人具有更高的IGF-1水平，這可能導致他們的骨骼、韌帶、關節更健康，代謝狀態最佳化。
無氧運動/高強度運動在相同的能量消耗下，比有氧運動產生更大的腹部脂肪減少[98]。Blomster等人研究了11140名糖尿病患者，發現與不進行或輕度運動的患者相比，中度至劇烈運動的患者發生心血管事件的風險降低22%、微血管並行癥少15%、全因死亡率降低17%。
所以不難理解為什麽美國運動醫學院推薦超重/肥胖者也進行抗阻訓練[100]。
三、肌肉訓練的更大意義體現在生命力薄弱、身體差的老年人身上
例如抑郁癥，一種嚴重降低生活品質的疾病，許多抑郁癥患者 自殺 [101,102,103,104]。體力活動可以可以提升身體活力，改善生活品質，對抗抑郁癥[105,106,107,108]；抗阻訓練也被證明有助於降低抑郁程度[109,110]。
老年人容易發生大腦功能衰退，許多大型研究表明肌肉力量和大腦功能具有密切關系，肌肉力量較強者的反應、邏輯、記憶、認知能力都更高[112,113,114,115,116]。肌肉力量強和大腦功能好兩者之間並不只是單純的同時發生，也有 明確的因果關系 。
Mavros等人設計了雙盲/雙假實驗研究了100名55歲以上患有輕度認知障礙的老人[111]，在專業培訓師的監督下，他們進行的為期6個月的漸進負荷力量訓練（負荷為80-92%的大強度）。訓練提高了老人的力量和認知能力，他們的阿茨海預設知表中的得分顯著改善。特別值得一提的是，Mavros等人還研究並排出了肌肉力量與認知之間的反向因果關系， 確認了是肌肉力量提高了認知水平 。
這樣的研究結論被一而再再而三的復制、被反復論證。
Roberta對65歲以上老人進行3個月的漸進力量訓練，方案包括腿屈伸、腿彎舉、臥推、劃船、箭步蹲、拉伸、自重訓練等，促進了他們神經功能和執行能力的改善[117]；
Carla等人對67名55-75歲的健康老年人進行16周的力量訓練，在進行思維任務期間，他們大腦左前額葉皮層耗氧量下降，運動訓練使大腦皮層啟用時的腦氧合效率更高，認知表現（反應時間）得到改善[118]；
Lindsay等人對86名70至80歲的婦女進行了為期6個月的隨機對照試驗，發現每周兩次的力量訓練可以改善她們的註意力、選擇性、聯想記憶功能，而平衡和協調性訓練則不能[119]；
Fia等人100名患有輕度認知障礙的老年人[121]，6個月的力量訓練改善阿茨海默平分表48%、無阻力訓練改善27%、認知訓練則無改善只減輕了記憶力的下降。
Tsai等人從大學醫院阿茨海默研究中心招募了66名患有認知障礙的老年人（60至80歲）進行實驗，證實有氧/力量訓練後他們的認知改善，反應時間縮短[120]。
在更宏觀的層面上，Sarah等人對47個列隊研究進行了 元分析 ，得出體力活動與認知能力下降和癡呆呈顯著的負相關關系。體力活動與認知障礙風險減少35%、癡呆風險14%有關；
這些內容我以前寫過，就不詳細鋪開了。
如何看待中國老年人健身很少進行力量訓練，而是采取快走等有氧耐力運動？
此外，肌肉訓練防止摔倒骨折等。對於老年人來說，一次摔倒引發的骨折，結果可能是住院、臥床、喪失行動能力、健康狀況惡化、乃至死亡，網傳袁老就是在一次摔倒後身體狀況急劇惡化的。
此外，就算沒有骨折，長期力量訓練也有助於減少受傷機率和降低傷情，因為負重可導致骨密度提高、韌帶、肌腱、肌肉的韌性/彈性加強。
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