The Question We Should Really Be Asking
If you’ve spent any time reading exercise science research lately (or even scrolling through social media), you’ve probably noticed an interesting debate beginning to emerge.
On one side are researchers and clinicians arguing that skeletal muscle mass remains one of the strongest predictors of long-term health and longevity. On the other hand, there are those suggesting that strength, muscle power, gait speed, cardiorespiratory fitness, or even metabolic health may be more meaningful indicators than muscle size alone.
At first glance, those positions seem contradictory.
After spending considerable time working through the literature, however, I’m not convinced the disagreement is really about the science. I think it’s about the question we’re asking.
Rather than asking whether muscle mass matters, perhaps we should be asking a different question altogether:
Which characteristics of skeletal muscle best predict long-term health, function, and longevity?
That subtle shift changes the conversation considerably. As clinicians, coaches, and exercise professionals, we naturally look for a single metric that tells us everything we need to know about a client’s health. It would certainly make our jobs easier. Unfortunately, human physiology rarely works that way.
Skeletal muscle is remarkably complex. It has size, certainly, but it also has quality, strength, power, endurance, metabolic activity, and an extraordinary ability to adapt throughout the lifespan. Each of those characteristics tells us something slightly different about the person standing in front of us, and each contributes to health through distinct yet interconnected physiological pathways (Bennett et al., 2025; Hoffmann & Weigert, 2017; Kirk et al., 2024).
Interestingly, this broader perspective reflects one of the biggest shifts that has occurred in exercise physiology over the past two decades.
For years, skeletal muscle was viewed primarily as the tissue responsible for producing movement. While that remains true, researchers now recognize that muscle is also one of the body’s largest metabolic organs. It influences glucose regulation, insulin sensitivity, inflammation, energy expenditure, and communicates with numerous organ systems through signaling molecules known as myokines (Handschin et al., 2007; Hoffmann & Weigert, 2017; Smith et al., 2018).
In other words, muscles don’t simply help us move. It helps regulate how we function.
For personal trainers, that realization has important implications. It changes how we evaluate progress, interpret body composition assessments, and ultimately define success. A client’s muscle health cannot be fully understood through a single scan, a single strength test, or a single number on the scale. Instead, it requires us to consider multiple characteristics working together—muscle quantity, muscle quality, functional performance, and metabolic capacity.
In many ways, that’s where this entire discussion begins.
Why Scientists Sometimes Disagree
One reason this topic has become surprisingly controversial is that researchers often study different aspects of skeletal muscle while attempting to answer distinct questions.
Take body composition, for example.
Dual-energy X-ray absorptiometry (DXA) remains one of the most widely used tools for estimating lean tissue because it is relatively accessible, cost-effective, and practical in both research and clinical settings. However, despite how commonly it is used, DXA does not directly measure skeletal muscle. Instead, it estimates appendicular lean soft tissue, a measurement that includes skeletal muscle alongside other non-fat, non-bone tissues (Bennett et al., 2025; Kim et al., 2004).
That distinction may sound like semantics, but it actually matters.
Bennett and colleagues (2025) recently argued that inconsistent terminology surrounding DXA-derived measurements has contributed to confusion throughout both the scientific literature and clinical practice. When investigators use slightly different definitions of “muscle mass,” comparisons between studies become more difficult, and clinicians may unintentionally overinterpret what a particular measurement actually represents (Bennett et al., 2025).
More recently, another technique—the D3-creatine dilution method—has generated considerable interest because it appears to estimate actual skeletal muscle tissue more directly than DXA (Wimer et al., 2023). Studies using this approach have demonstrated meaningful relationships between lower muscle mass and mobility disability, fracture risk, and declining physical function in older adults (Cawthon et al., 2022; Zanker et al., 2020).
Rather than suggesting that muscle mass is unimportant, these findings highlight something much more interesting: different measurement tools are often capturing different aspects of the same biological system.
The story becomes even more nuanced when researchers use imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI). Beyond simply estimating muscle size, these methods can evaluate muscle composition, radiodensity, and intramuscular fat infiltration (Ha et al., 2021; Rollins et al., 2019; Zaffina et al., 2021). Although these techniques provide exceptional detail, they are considerably less practical for routine fitness assessments because of cost, accessibility, and clinical logistics.
None of these methods is inherently wrong. They’re simply measuring different characteristics of skeletal muscle. Once you begin looking at the literature through that lens, many of the apparent disagreements start to make much more sense.
I often think of it like evaluating a car. One mechanic may focus on engine size. Another may care more about horsepower. A third might evaluate fuel efficiency, while a fourth concentrates on braking performance. Each measurement provides useful information, but none fully describes the vehicle on its own.
The same principle applies to skeletal muscle. As exercise professionals, our responsibility isn’t to champion one assessment method over another. It’s to understand what each measurement tells us—and, equally importantly, what it doesn’t.
From that perspective, the conversation becomes much richer.
Instead of asking whether muscle mass matters, we begin recognizing that muscle health is inherently multidimensional. Muscle quantity is certainly part of the story, but so are strength, muscle power, muscle quality, cardiorespiratory fitness, and metabolic function. Each contributes unique information about an individual’s overall health, resilience, and functional capacity (Bohannon, 2019; Forman et al., 2017; Jiménez-Lupión et al., 2025; Lehn-Stefan et al., 2022).
Perhaps that’s the first major takeaway from this discussion. The literature isn’t necessarily arguing over which variable matters most.
Increasingly, it’s teaching us that healthy skeletal muscle cannot be reduced to any single measurement.
Muscle Health Is More Than Muscle Mass
Once we move beyond the question of how muscle is measured, a much more interesting question emerges.
What is it about skeletal muscle that actually predicts health?
If you’ve followed this area of research over the past several years, you’ve probably noticed what appears to be an ongoing disagreement. Some investigators argue that muscle mass is one of the strongest predictors of healthy aging and longevity. Others suggest that muscle strength, muscle power, gait speed, or cardiorespiratory fitness may be even more important.
At first glance, those conclusions seem difficult to reconcile. In my humble opinion, they aren’t.
In many ways, they’re simply describing different dimensions of the same physiological system.
Think about the clients you work with every day. Rarely do we judge someone’s physical capacity based on a single characteristic. We don’t evaluate an athlete solely by how much muscle they carry, nor do we determine whether an older adult can live independently by looking only at a body composition report.
Instead, we naturally ask a much broader set of questions.
- How strong are they?
- How well do they move?
- Can they produce force quickly?
- Do they recover well?
- Can they confidently perform the activities that matter most to them?
In other words, we’re already evaluating muscle health as something multidimensional. Interestingly, the scientific literature is beginning to move in the same direction.
Muscle Quantity Provides Capacity
To be clear, there is very little debate that skeletal muscle mass remains an important physiological reserve.
Skeletal muscle serves as the body’s largest reservoir of amino acids, contributes substantially to resting metabolic rate, and provides the structural foundation from which force can ultimately be generated (Hoffmann & Weigert, 2017; Strasser et al., 2018). Across aging populations, lower muscle mass has consistently been associated with greater risks of mobility disability, fractures, frailty, hospitalization, and mortality (Cawthon et al., 2022; Damluji et al., 2023; Xu et al., 2021; Zanker et al., 2020).
In fact, a large meta-analysis reported that sarcopenia is associated with a significantly greater risk of all-cause mortality regardless of the diagnostic criteria used (Xu et al., 2021). Likewise, contemporary consensus statements continue to recognize muscle mass as a fundamental component of sarcopenia, while acknowledging that strength and muscle-specific function deserve equal consideration (Kirk et al., 2024).
So, if you’ve encountered someone claiming that “muscle mass doesn’t matter anymore,” the current evidence simply doesn’t support that conclusion.
At the same time, I think it’s equally important not to overcorrect in the opposite direction. Muscle mass clearly matters. It just isn’t the entire story.
Why Muscle Quality Matters
One of the most fascinating developments in recent years has been the growing appreciation for muscle quality.
Consider two individuals with nearly identical amounts of skeletal muscle.
One is strong, metabolically healthy, and moves effortlessly. The other struggles with balance, fatigues quickly, and demonstrates relatively poor functional performance.
How can that happen?
Because muscle isn’t simply contractile tissue.
As we age—or as metabolic dysfunction develops—skeletal muscle undergoes a variety of structural and physiological changes. Intramuscular fat begins to accumulate. Capillary density declines. Mitochondrial function becomes impaired. Muscle fiber characteristics change, and connective tissue architecture remodels over time (Gavin et al., 2004; Marcus et al., 2012; Mogensen et al., 2007; Pinel et al., 2021).
Collectively, these adaptations reduce the efficiency of skeletal muscle in performing its job.
That helps explain why muscle size alone doesn’t always predict real-world function.
Marcus and colleagues (2012), for example, found that intramuscular adipose tissue explained more variation in mobility than lean tissue alone. Similarly, Pinel and colleagues (2021) demonstrated that age-related increases in intramuscular fat were associated with poorer muscle mechanical properties and diminished strength, even when overall muscle volume remained relatively stable.
For personal trainers, that’s an important distinction.
Building muscle remains worthwhile. However, building healthy muscle is even better.
Strength and Power Tell Us How Muscles Perform
This is where I think personal trainers have a unique advantage. Clients rarely celebrate because they’ve added 0.7 kilograms of appendicular lean soft tissue. Instead, they tell us something like:
- “I carried all the groceries in one trip.”
- “Getting off the floor doesn’t hurt anymore.”
- “I kept up with my grandchildren this weekend.”
- “Stairs don’t leave me winded like they used to.”
Notice what’s happening. Those aren’t conversations about muscle mass. They’re conversations about function.
Perhaps that’s why grip strength has received so much attention over the past decade. Despite its simplicity, lower grip strength has consistently been associated with greater risks of cardiovascular disease, hospitalization, disability, cognitive decline, and all-cause mortality across diverse populations (Bohannon, 2019; Lee, 2019; Xiong et al., 2023). Interestingly, relative grip strength—strength normalized to body size—may predict cardiometabolic health even more effectively than absolute grip strength alone (Lee et al., 2016).
Even so, grip strength is only one piece of the puzzle.
Gait speed has emerged as another remarkably powerful predictor of future health because it reflects the integrated performance of multiple physiological systems simultaneously, including lower-body strength, balance, neuromuscular coordination, and cardiovascular function (Lee et al., 2020; Manzo et al., 2022; Melo et al., 2023; Takino et al., 2026).
Then there’s muscle power.
Per my last article series, unlike maximal strength, which reflects how much force can be produced, power reflects how quickly that force can be generated. In everyday life, that distinction matters. Power often determines whether someone can catch themselves after tripping, rise quickly from a chair, or confidently climb a flight of stairs.
Interestingly, muscle power appears to decline earlier than maximal strength with aging and may actually be a stronger predictor of functional independence in older adults (Alcazar et al., 2020; Jiménez-Lupión et al., 2025). Encouragingly, power-oriented resistance training also appears capable of producing larger improvements in functional performance than traditional strength training alone in many older populations (Marsh et al., 2009).
Stepping back, a clear pattern begins to emerge.
- Muscle quantity provides capacity.
- Muscle quality determines efficiency.
- Strength demonstrates capability.
- Power reveals how effectively that capability can be expressed during everyday movement.
Rather than competing explanations, each tells us something unique about the same physiological system.
Perhaps that’s the larger lesson. The question isn’t whether muscle mass, strength, or power is “most important.” It’s understanding how all of them work together to influence health, performance, and independence across the lifespan.
Skeletal Muscle: More Than a Mechanical Tissue
If the first part of this discussion encourages us to think differently about muscle health, the next question becomes even more interesting.
Why does skeletal muscle influence so many aspects of health in the first place?
For decades, most anatomy and physiology textbooks described skeletal muscle primarily as a mechanical tissue. Its role was straightforward: produce force, create movement, maintain posture, and stabilize joints.
All of those functions remain true, but they’re no longer the complete story.
One of the biggest conceptual shifts in exercise physiology has been the recognition of skeletal muscle as one of the body’s largest metabolic organs (Hoffmann & Weigert, 2017). That isn’t simply an academic reclassification. It fundamentally changes how we think about resistance training.
When clients improve their muscular fitness, they aren’t simply becoming stronger. They’re remodeling a tissue that communicates continuously with virtually every major organ system in the body.
One of skeletal muscle’s most important responsibilities is regulating blood glucose. Following a carbohydrate-containing meal, skeletal muscle accounts for a substantial proportion of insulin-stimulated glucose disposal, serving as an enormous reservoir that removes glucose from circulation and stores it for future energy demands (Holten et al., 2004; Turner et al., 2013).
Perhaps even more encouraging is that resistance training improves many of these metabolic processes independent of weight loss. Increases in GLUT4 expression, improved insulin receptor signaling, and enhanced glycogen storage have all been observed following resistance training—even among individuals living with Type 2 diabetes (Holten et al., 2004).
That’s a powerful message for our clients.
Sometimes the most meaningful adaptations are happening long before the mirror—or the scale—reflects them.
Researchers have also discovered that contracting skeletal muscle releases signaling molecules known as myokines, allowing muscle tissue to communicate with organs throughout the body (Hoffmann & Weigert, 2017). Collectively, these molecules appear to influence glucose metabolism, fat oxidation, angiogenesis, immune regulation, inflammation, cognition, and numerous aspects of systemic health (Hoffmann & Weigert, 2017; Kong et al., 2025).
In many respects, every resistance training session represents a coordinated conversation between skeletal muscle and the rest of the body.
That perspective also helps explain why muscle quality matters metabolically, not just mechanically. As intramuscular fat accumulates and mitochondrial function declines, skeletal muscle becomes less efficient at utilizing glucose and fatty acids, contributing to insulin resistance and chronic metabolic dysfunction (Blackwood et al., 2022; Gavin et al., 2004; Mogensen et al., 2007).
This is also why I hesitate whenever muscle and fat are portrayed as physiological enemies. Truth be told, reality is much more nuanced.
For example, adipose tissue performs important endocrine functions and is essential for normal physiology. The problem isn’t fat itself. The problem is excessive visceral and ectopic fat accumulation, particularly within organs such as the liver, pancreas, heart, and skeletal muscle, where it becomes strongly associated with systemic inflammation, insulin resistance, cardiovascular disease, and metabolic dysfunction (Luo et al., 2025; Trouwborst et al., 2018).
Once again, the conversation becomes much richer than simply discussing body weight.
Two people with identical BMIs can possess dramatically different distributions of muscle tissue, visceral fat, and ectopic fat—and, consequently, dramatically different cardiometabolic risk profiles. That’s one reason researchers increasingly emphasize relative measures, such as relative muscle mass and relative handgrip strength, rather than relying exclusively on absolute values (Donini et al., 2022; Lee et al., 2016).
Stepping back, perhaps the most interesting pattern is this: Every time researchers identify another important predictor of health—whether grip strength, gait speed, muscle power, cardiorespiratory fitness, or muscle quality—they aren’t replacing muscle mass.
They’re adding another piece to an increasingly complete picture.
As exercise professionals, our goal shouldn’t be to identify a single “best” metric. It should be learning how these variables complement one another, so we can better understand the people standing in front of us.
Ultimately, that’s where I think the future of exercise science is heading—not toward one perfect measurement, but toward a richer, more integrated understanding of human health and performance.
What This Means for Personal Trainers
So, where does all of this leave the personal trainer?
I would argue that it leaves us with both a tremendous responsibility and an equally exciting opportunity.
For decades, much of our profession has centered on changing body composition. Clients come to us wanting to lose weight, reduce body fat, or build muscle, and those outcomes have understandably become the benchmarks by which many people judge success.
Yet the literature we’ve explored throughout this article suggests that these measurements are often serving as proxies for something much more meaningful.
People aren’t pursuing muscle simply for the sake of having more muscle. They’re pursuing what healthy muscle allows them to do. That distinction changes everything.
A client who improves insulin sensitivity, develops greater lower-body power, walks with more confidence, carries groceries without discomfort, and remains physically independent into later life has experienced an extraordinary physiological transformation—even if the scale barely moves.
As coaches, we have the privilege of helping clients pursue those outcomes every single day.
In many ways, I think this is where our profession is evolving. Historically, personal trainers have often been viewed as exercise instructors or body transformation specialists. While those roles remain important, I suspect we’ll increasingly become something else as well: translators of human physiology.
As a result, our job extends well beyond prescribing exercises or counting repetitions. We help people understand whyresistance training matters. We explain why skeletal muscle influences metabolic health, healthy aging, disease prevention, and long-term quality of life. Perhaps most importantly, we remind clients that some of the most meaningful adaptations are happening long before they’re visible in the mirror.
That requires scientific literacy, but it also requires comfort with nuance.
One of the easiest traps to fall into—especially in today’s social media environment—is believing that every scientific discussion must produce a winner. For example: Muscle mass versus strength; resistance training versus cardiovascular exercise; protein versus calories; fat loss versus performance, etc.
Those debates make for compelling headlines, but human physiology rarely operates in absolutes.
If there’s one consistent message running throughout the literature reviewed here, it’s that integration is almost always more informative than opposition. Muscle quantity matters. Muscle quality matters. Strength matters. Power matters. Cardiorespiratory fitness matters. Body fat distribution matters. Rather than competing explanations, these characteristics interact continuously to influence health, function, disease risk, and longevity (Bennett et al., 2025; Forman et al., 2017; Kirk et al., 2024).
Personally, I find that perspective incredibly liberating. It reminds us that our job isn’t to chase a single “perfect” metric. Instead, we can ask much richer questions.
- Is this client becoming stronger?
- Are they moving with greater confidence?
- Can they tolerate more work than they could six months ago?
- Is recovery improving?
- Do everyday activities feel easier?
- Do they feel more capable living their life?
Those questions often reveal far more about meaningful progress than any individual body composition measurement ever could. They also change the conversations we have with clients.
Imagine explaining that resistance training isn’t simply helping someone “build muscle.” Instead, they’re improving one of the body’s largest metabolic organs—one that influences glucose regulation, inflammation, movement quality, and healthy aging.
Suddenly, exercise becomes much larger than aesthetics. It becomes an investment in resilience. I suspect that’s where the future of personal training is heading.
As exercise science continues to evolve, clients will increasingly arrive having listened to podcasts, watched debates online, or read headlines claiming that one variable is “everything” while another “doesn’t matter anymore.”
Our responsibility isn’t to amplify those false dichotomies. Rather, our responsibility is to provide context.
Perhaps that’s the biggest lesson from this entire discussion. The question was never whether muscle mass matters. Of course it does.
The more interesting question is how muscle quantity, muscle quality, strength, power, metabolic health, and cardiorespiratory fitness interact to influence human performance across the lifespan.
Once we begin asking that question instead, many of the apparent disagreements within the literature become far less contradictory.
In many cases, they become complementary.
Conclusion
At first glance, the debate surrounding skeletal muscle appears surprisingly polarized. Depending on which article, podcast, or social media discussion you encounter, muscle mass is either presented as the defining predictor of health or dismissed in favor of strength, gait speed, power, or cardiorespiratory fitness.
The current literature supports neither extreme. Instead, it paints a much richer picture.
Skeletal muscle is simultaneously a mechanical tissue, a metabolic organ, and an adaptive physiological system that influences movement, glucose regulation, inflammation, functional independence, and healthy aging (Bennett et al., 2025; Hoffmann & Weigert, 2017; Kirk et al., 2024).
Understanding that complexity requires us to move beyond either-or thinking and recognize that different measurements answer different questions.
For personal trainers, I think that’s encouraging. It reminds us that our profession has never really been about helping people chase numbers.
It’s about helping people become more capable, more resilient, more independent, and more confident as they move through their lives.
Perhaps that’s why I believe the biggest debate in exercise science is asking the wrong question.
The question has never been whether muscle mass matters.
The real question is how we preserve every characteristic of healthy skeletal muscle—from its quantity and quality to its strength, power, and metabolic function—so that the people we work with can continue living active, healthy, and meaningful lives for decades to come.
From that perspective, the science becomes considerably less confusing and perhaps considerably more useful.
Practical Takeaways for Personal Trainers
If there’s one practical lesson I hope readers take away from this discussion, it’s that healthy skeletal muscle is far too complex to be captured by a single number.
As researchers continue refining how we measure muscle and which variables best predict long-term health, several practical implications already seem remarkably clear.
First, resist the temptation to evaluate clients using only one metric. Body weight, body fat percentage, appendicular lean mass, grip strength, gait speed, muscle power, and aerobic capacity each contribute valuable information, but none tells the complete story on its own.
Second, continue making progressive resistance training a cornerstone of your programming. Regardless of which physiological outcome researchers emphasize, resistance training consistently improves multiple characteristics of healthy skeletal muscle simultaneously, including muscle quantity, muscle quality, strength, metabolic health, and functional capacity (Hoffmann & Weigert, 2017; Kirk et al., 2024).
Third, remember that your clients are rarely pursuing laboratory values. They’re pursuing better lives.
Whether they want to hike with family, remain independent as they age, better manage diabetes, reduce cardiometabolic risk, or simply feel more confident in their own body, improvements in skeletal muscle function support virtually every one of those goals.
Finally, embrace scientific nuance. Exercise science will continue to evolve. New studies will continue challenging old assumptions. Rather than viewing those changes as contradictions, view them as opportunities to deepen your understanding.
The strongest coaches are rarely the ones with the simplest answers. They’re the ones who understand complexity well enough to explain it simply.
As our understanding of skeletal muscle continues to grow, one conclusion seems increasingly difficult to ignore.
Healthy muscle is about far more than muscle mass alone. Perhaps the future of personal training isn’t helping people build bigger muscles. It’s helping them build better muscles.
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