February 12, 2026, 6:53 pm | Read time: 7 minutes
Chronic inflammations work in the body for years–often completely unnoticed. The problem: In the long term, this process triggers six disease and degeneration processes, which our author Prof. Thomas Kälicke, chief physician and longevity expert, calls “silent killers.” At FITBOOK, he presents a concrete strategy for everyday life to keep them in check. Strength training plays a key role in this.
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These Are the 6 “Silent Killers” in the Body
Chronic, low-grade inflammations play a central role in the aging process, smoldering so quietly over decades that we hardly notice them. This process, known in research as inflammaging, triggers six central disease and degeneration processes in the long term. In my book “LNGVTY,” I refer to them as “silent killers” in the body and as the deadly sextet.
The deadly sextet includes:
- Metabolic disorders
- Cardiovascular disorders
- Cancer
- Dementia
- Bone, cartilage, and muscle degeneration
- Microbiome disorders
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Research Shows: Good Musculature with Many Myokines Protects Against “Silent Killers”
Chronic inflammations trigger all these disorders or diseases, but they are not the only cause, especially in cancer and dementia. What research also clearly shows: Good musculature with many myokines protects against “silent killers.”
A central strategy against the “silent killers” in the body therefore starts where inflammations arise: It aims to produce as many anti-inflammatory myokines as possible through active musculature while reducing pro-inflammatory adipokines from visceral fat.
About the author: Prof. Dr. med. Thomas Kälicke is a specialist in surgery, orthopedics, and trauma surgery with additional qualifications in special trauma surgery, hand surgery, and physical therapy. In early 2011, he became chief physician at the GFO Clinics Bonn at the age of 38. Since 2025, he has also been the chief physician of general surgery at the CURA Hospital in Bad Honnef. In addition to his clinical work, he has been advising and accompanying people who want to change their lifestyle and stay healthy in the long term for many years. As a sought-after speaker, he conveys scientifically sound insights into longevity in an understandable and practical way.
Muscles as a Key Part of the Solution
Muscles are usually considered purely as organs of movement. They keep us upright, stabilize joints, and enable activity. In fact, they are much more: Musculature is a hormone-like organ that actively produces messenger substances and releases them into the bloodstream–the aforementioned myokines.
During physical activity, especially muscle contraction, these myokines are formed and released. Through them, the musculature communicates with other organs and influences central processes such as metabolism, fat breakdown, insulin sensitivity, immune function, and inflammation regulation. This function of the musculature was long underestimated. Today it is clear: Myokines are not incidental byproducts of movement but central control factors for health and aging processes.
Myokines – Anti-inflammatory Protective Factors
Today, several hundred different myokines are known, and their exact number is still the subject of research. What is certain, however, is that they form a complex network through which musculature has a far-reaching impact on the entire organism.
Typical myokines include interleukin-6, which acts anti-inflammatory after physical activity and supports metabolic regulation, irisin, which promotes fat burning and activates brown fat tissue, and BDNF, which supports brain function, mood, and neuronal plasticity. FGF21 is also among the relevant myokines: It regulates energy metabolism and helps improve insulin sensitivity. Myostatin plays a special role as it limits muscle growth and can be specifically inhibited through training.
A special subgroup is the so-called exakines. They are released mainly during intense muscle exertion and mediate particularly anti-inflammatory and metabolism-regulating effects. Exakines are thus considered those myokines that contribute particularly strongly to the control of chronic inflammatory processes during high muscular activity.
Overall, myokines act like a body’s own protective system. They can contain the inflammatory wildfire or prevent its formation from the outset. Where initial inflammatory changes have already formed, they act metaphorically like a biological rust converter.
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What Promotes the 6 “Silent Killers” in the Body – Adipokines, Belly Fat, Muscle Loss
Opposite the protective myokines are the adipokines: hormone-like messengers from white fat tissue, especially from visceral fat around the abdominal organs. They also actively intervene in metabolic and inflammatory processes–however, their effect differs fundamentally from that of myokines.
With increasing fat mass, especially in the abdominal area, the release of pro-inflammatory adipokines increases significantly. These include TNF-alpha as a central driver of chronic inflammation, interleukin-6 from fat tissue, which maintains low-grade inflammatory processes, resistin as a promoter of insulin resistance, and leptin, which is often misregulated in overweight individuals. In this constellation, adipokines act like accelerants for the inflammatory wildfire in the body.
Not all fat tissue is problematic. In addition to white fat, there is a comparatively small amount of brown fat. It is metabolically active, burns energy, and has anti-inflammatory effects. Brown fat is closely functionally linked to myokines and is activated, among other things, by movement and cold stimuli. Cold exposure, such as ice bathing, can increase this activity. This is not a cure-all but illustrates that fat tissue is not a passive energy store but a dynamic organ with very different effects. (Read here where exactly the brown fat is located in the body).
From the age of 30, muscle loss begins insidiously without targeted training. The body weight often does not decrease–rather, muscle mass is gradually replaced by fat. This shift goes unnoticed for a long time because little changes on the scale. People are particularly at risk during the life phase between about 30 and 50 years. During this time, many people are heavily involved in their careers and families, and physical activity takes a back seat. However, hormonally, an unfavorable shift is already taking place: fewer myokines, more adipokines.
In the long run, this results in two effects: less strength and stability with an increased risk of falls and injuries, as well as reduced myokine production, which promotes chronic inflammation and age-associated diseases.
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My 7 Rules as a Strategy Against the 6 “Silent Killers”
My seven rules aim to increase myokine production, reduce pro-inflammatory adipokines, and thus specifically keep the “silent killers” in the body in check through regular exercise–especially strength training–sufficient protein, good sleep, stress reduction, and little visceral fat.
1. Regular Strength Training
Strength training is the most important stimulus for myokine production. It maintains muscle mass, prevents age-related muscle loss, and keeps the musculature hormonally active–even in older age.
2. Endurance Training Combined with Intense Loads
Endurance training reduces visceral fat and thus inflammatory adipokines. Occasional intense load peaks are also useful, as different training stimuli activate different myokines.
3. Protein-rich, Balanced Diet
A sufficient protein intake supports muscle building and maintenance. At the same time, a balanced diet helps limit pro-inflammatory fat deposits and shift the hormonal balance in favor of myokines.
4. Lots of Movement in Everyday Life
Not only training counts. Every form of everyday movement promotes the release of myokines and dampens inflammatory processes. Prolonged sitting works in the opposite direction.
5. Targeted Cold Stimuli
Cold stimuli, such as cold showers or ice bathing, can activate brown fat and support anti-inflammatory metabolic pathways–especially in combination with regular exercise.
6. Sufficient Sleep and Stress Reduction
Chronic stress and lack of sleep increase stress hormones, promote muscle loss, and favor inflammation. Regeneration is therefore a central component for a stable myokine-adipokine balance.
7. Keep Visceral Fat Consistently Low
Visceral fat is the most important source of inflammatory adipokines. The smaller this fat depot, the lower the inflammatory baseline in the body–and the better myokines can unfold their protective effect.
Conclusion
The six “silent killers” in the body are more influenceable than we think. Through active musculature, targeted training, and lifestyle decisions, we can significantly influence our vital lifespan and keep the “silent killers” in the body at bay for a long time.
Targeted training, especially strength training, is the strongest physiological stimulus for the release of myokines. At the same time, regular exercise reduces visceral fat and thus the production of inflammatory adipokines. Musculature is therefore not only an organ of movement but a central hormonal control organ for inflammation, metabolism, and aging.
The central message is therefore: As much musculature and movement as possible–and as few pro-inflammatory fat deposits as necessary.