Tag Archives: resistance training

October 10, 2016 · 12:07 PM

Elders on a Weight-Loss Diet Preserve Bone Mineral Density With Resistance Training, Not Aerobic Exercise

…according to an article at MedPageToday.

"One more rep then I'm outa here!"

“One more rep then I’m outa here!”

In the study at hand, the two experimental groups had about 60 participants each, so it was a relatively small study. (In general, the larger the study, the more reliable the findings.) Most participants were white women; mean age was 69. The experimental intervention ran for five months. An excerpt:

In one trial, the participants were randomized to a structured resistance training program in which three sets of 10 repetitions of eight upper and lower body exercises were done 3 days each week at 70% of one repetition maximum for 5 weeks, with or without calorie restriction of 600 calories per day.
In the second study, participants were randomized to an aerobic program which was conducted for 30 minutes at 65% to 70% heart rate reserve 4 days per week, with or without calorie restriction of 600 calories per day.

The beneficial bone effect was seen at the hip but not the lumbar spine. (I’ve treated lots of hip and lumbar spine fractures. If I’m going to break one of those bones, I’d rather it be the spine.)

Thin old bones—i.e., osteoporotic ones—are prone to fractures. Maintaining or improving bone mineral density probably prevents age-related fractures. In a five-month small study like this, I wouldn’t expect the researchers to find any fracture rate reduction; that takes years.

Most mainstream articles on prevention and treatment of osteoporosis mention “weight-bearing” exercises as what you should do, like walking, jogging, tai chi, and volleyball. The current study adds resistance training to our therapeutic armamentarium. Resistance training is also called weight training or strength training.  

Most elders starting a weight-training program should work with a personal trainer.

Steve Parker, M.D.

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May 22, 2016 · 2:00 AM

QOTD: Gravity Versus Weight Training

Average age of study subjects was 71

A good resistance training program will strengthen her bones, improve her balance, and prevent that hip fracture 60 years from now

Adult life is a battle against gravity. Weight training postpones your inevitable defeat.

—Steve Parker, M.D.

PS: If you think gravity’s a bitch, you should see how many chapters are in my books.

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January 27, 2013 · 2:00 AM

Could Resistance Training Replace Slow Steady Cardio?

I was planning to review for you an article, Resistance Training to Momentary Muscular Failure Improves Cardiovascular Fitness in Humans: A review of acute physiological responses and chronic physiological adaptations.  It’s by James Steele, et al, in the Journal of Exercise Physiology (Vol. 15, No. 3, June  2012).

Exercise to momentary muscular failure may be safer on a machine

But it’s too technical for most of my readers. Heck, it’s too technical for me!  Too much cell biology and cell metabolism.  You’re dismissed now.

I’m just going to pull out a few pearls from the article that are important to me.  I ran across this in my quest for efficient exercise.  By efficient, I mean minimal time involved yet still effective.

The authors question the widespread assumption that aerobic and endurance training are both necessary for development of cardiovascular fitness.  Like Dr. Doug McGuff, they wonder if resistance training alone is adequate for the development of cardiovascular fitness.  Their paper is a review of the scientific literature.  The authors say the literature is hampered by an inappropriate definition and control of resistance training intensity.  The only accurate measure of intensity, in their view, is when the exerciser reaches maximal effort or momentary muscular failure.

The authors, by the way, define cardiovascular fitness in terms of maximum oxygen consumption, economy of movement, and lactate threshold.

“It would appear that the most important variable with regards to producing improvement in cardiovascular fitness via resistance training is intensity [i.e., to muscle failure].”

The key to improving cardiovascular fitness with resistance training is high intensity.  These workouts are not what you’d call fun.

From a molecular viewpoint, “the adenosine monophosphate–activated protein kinase pathway (AMPK) is held as the key instigator of endurance adaptations in skeletal muscle.  Contrastingly, the mammalian target of rapamycin pathway (mTOR) induces a cascade of events leading to increased muscle protein synthesis (i.e.,[muscle] hypertrophy).”  Some studies suggest AMPK is an acute inhibitor of mTOR activation.  Others indicate that “resistance training to  failure should result in activation of AMPK through these processes, as well as the subsequent delayed activation of mTOR, which presents a molecular mechanism by which resistance training can produce improvement in cardiovascular fitness, strength, and hypertrophy.”

You’re not still with me, are you?

“… the acute metabolic and molecular responses to resistance training performed to failure appear not to differ from traditional endurance or aerobic training when intensity is appropriately controlled.”

Chronic resistance training to failure induces a reduction in type IIx muscle fiber phenotype and an increase in type I and IIa fibers.  (Click for Wikipedia article on skeletal muscle fiber types.)

“It is very likely that people who are either untrained or not involved in organized sporting competition, but have the desire to improve their cardiovascular fitness may find value in resistance training performed to failure.  In fact, this review suggests that resistance training to failure can produce cardiovascular fitness effects while simultaneously producing improvements in strength, power, and other health and fitness variables. This would present an efficient investment of time as the person would not have to perform several independent training programs for differing aspects of fitness.”  [These statements may not apply to trained athletes.]

Before listing their 157 references, the authors note:

“It is beyond the scope of this review to suggest optimal means of employing resistance training (i.e., load, set volume, and/or frequency) in order to improve cardiovascular fitness since there are no published studies on this topic.”

In conclusion, if you’re going to do resistance training but not traditional aerobic/cardio exercise, you may not be missing out on any health benefits if you train with high  intensity.  And you’ll be done sooner.

Steve Parker, M.D.

PS: See Evidence-based resistance training recommendations by Fisher, Steele, et al.

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January 18, 2013 · 2:00 AM

QOTD: James Fisher on Efficient Resistance Exercise

We recommend that appreciably the same muscular strength and endurance adaptations can be attained by performing a single set of ~8–12 repetitions to momentary muscular failure, at a repetition duration that maintains muscular tension throughout the entire range of motion, for most major muscle groups once or twice each week. All resistance types (e.g. free-weights, resistance machines, bodyweight, etc.) show potential for increases in strength, with no significant difference between them, although resistance machines appear to pose a lower risk of injury.

—Fisher, James, et al.  Evidence-based resistance training recommendations.  Medicina Sportiva, 15 (2011): 147-162.

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May 10, 2012 · 2:00 AM

Time to Update Your Strength Training Regimen?

Not Chris Highcock

Strength training, also called resistance training, is an important method for controlling blood sugars without drugs in folks with diabetes.

A few months ago I read Hillfit: Stength, an ebook  by Chris Highcock of Conditioning Research.  It’s about  improvement of hiking skills and enjoyment via strength training with without having to join a gym or buy lots of equipment.  I’ve been on Chris’s program for the last five weeks.

One of the scientific review articles he cites in support of his recommendations is an eye-opener.  Evidence-Based Resistance Training Recommendations is available free online.  It’s published in Medicina Sportiva, which I’m not familiar with.  I’ll confess I’ve read little of the hard-core literature on the science of strength training.  It’s one of my more recent interests.

An excerpt:

We recommend that appreciably the same muscular strength and endurance adaptations can be attained by performing a single set of ~8-12 repetitions to momentary muscular failure, at a repetition duration that maintains muscular tension throughout the entire range of motion, for most major muscle groups once or twice each week. All resistance types (e.g. free-weights, resistance machines, bodyweight, etc.) show potential for increases in strength, with no significant difference between them, although resistance machines appear to pose a lower risk of injury.

The article has got me questioning some of my long-held notions, such as how often to work out, number of reps moving a weight, speed of moving a weight, and whether I should stick with the free weights I tend to prefer.  Why not see if your dogma is supported?  Worth a look.

Steve Parker, M.D.

Fisher, James, et al.  Evidence-based resistance training recommendations.  Medicina Sportiva, 15 (2011): 147-162.

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February 8, 2011 · 11:54 AM

Exercise, Part 4: Strength Training

What’s “strength training”? It’s also called muscle-strengthening activity, resistance training, weight training, and resistance exercise. Examples include lifting weights, work with resistance bands, digging, shoveling, yoga, push-ups, chin-ups, and other exercises that use your body weight or other loads for resistance.

Strength training three times a week increases your strength and endurance, allows you to sculpt your body to an extent, and counteracts the loss of lean body mass (muscle) so often seen during efforts to lose excess weight. It also helps maintain your functional abilities as you age. For example, it’s a major chore for many 80-year-olds to climb a flight of stairs, carry in a bag of groceries from the car, or vacuum a house. Strength training helps maintain these abilities that youngsters take for granted.

According to the U.S. Centers for Disease Control and Prevention: “To gain health benefits, muscle-strengthening activities need to be done to the point where it’s hard for you to do another repetition without help. A repetition is one complete movement of an activity, like lifting a weight or doing a sit-up. Try to do 8–12 repetitions per activity that count as 1 set. Try to do at least 1 set of muscle-strengthening activities, but to gain even more benefits, do 2 or 3 sets.”

 If this is starting to sound like Greek to you, consider instruction by a personal trainer at a local gym or health club. That’s a good investment for anyone unfamiliar with strength training, in view of its great benefits and the potential harm or waste of time from doing it wrong. Alternatives to a personal trainer would be help from an experienced friend or instructional DVD. If you’re determined to go it alone, Internet resources may help, but be careful. Consider “Growing Stronger: Strength Training for Older Adults” (http://www.cdc.gov/physicalactivity/downloads/growing_stronger.pdf). Don’t let the title turn you off if your young—its a good introduction to strenght training for folks of any age. Doug Robb’s blog, HealthHabits, is a wonderful source of strength training advice (http://www.healthhabits.ca/). The Internet resources I’ve mentioned are not designed specifically for people with diabetes.

Current strength training techniques are much different than what you remember from high school 30 years ago—modern methods are better. Some of the latest research suggests that strength training may be even more beneficial than aerobic exercise.

Next, Part 5 reviews aerobic training.

Steve Parker, M.D.

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November 30, 2010 · 7:39 AM

Aerobic vs Strength Training: Which Improves Diabetes More?

Judging from improvement in hemoglobin A1c, the combination of aerobic and strength training is needed to improve diabetic blood sugar levels.  Both types of exercise—when considered alone—did not improve diabetes control, according to the latest research in the Journal of the American Medical Association.

One type of resistance training

One of the things that impressed me about Dr. Richard Bernstein’s book, Diabetes Solution, was his strong advocacy of weight training, also known as resistance training and strength training.  Weight lifting is a typical example.

Prior studies had shown exercise-induced  improvements (reductions)  in hemoglobin A1c, a great test for overall diabetes control, in the range of o.66% to 1.0% (absolute change, not relative).  That’s comparable to what we see with many drugs.  Much easier to pop a pill though, huh?

One earlier study showed hemoglobin A1c lowered by 0.4% with resistance training, 0.5% with aerobic training, and 1.0% with combined resistance/aerobic.  But folks doing both aerobic and resistance were exercising 270 minutes a week—39 minutes a day—which was significantly more than the people just doing one type of exercise. [This was the DARE study: Diabetes Aerobic and Resistance Exercise.] 

Investigators at the Pennington Biomedical Research Center in Louisiana wondered which type of exercise would be more effective, comparing the same minutes per week of activity.

Methodology

They randomized 262 sedentary type 2 diabetics to one of four groups: control, aerobic exercise, resistance training 3 days a week, or combined aerobic and resistance training (resistance twice weekly).  All three groups exercised for about 140 minutes a week—just 20 minutes a day, on average—for nine months.  Exercise intensity was 50 to 80% of maximum oxygen consumption (determined by a baseline treadmill stress test).  Nearly all participants were on diabetic drugs; 18% were on insulin.  I think the aerobic group exercised on treadmills.

Participant characteristics:  Women were 64% of the total.  Average age 56. Forty-seven percent were non-white (114 black, 10 Hispanic/other).  Average body mass index was 35.  Average hemoglobin A1c was 7.7%.  Not too many people dropped out of the study before it was over.

Results

No serious adverse event occurred during exercise.  The authors didn’t mention the occurence of hypoglycemia.

The combination training group dropped their hemoglobin A1c average by 0.34% (p = 0.03). The pure resistance and aerobic exercisers didn’t show any improvement over the control group.

The combination group lost 1.6 kg body weight on average compared to the control group.  Pure resistance and aerobic exercisers’ weights didn’t differ from the control group. [Remember, this was not a weight-loss study.]

Comments

The authors write:

The failure of the aerobic group to lose a substantial amount of weight (or fat) has been reported in numerous aerobic exercise trials, which may be due to aerobic training resulting in [higher] energy intake, expenditure compensation, or both.

If you’re trying to lose excess fat weight, resistance training appears to win over aerobic exercise.

Doing either aerobic execise or resistance exercise for an average of 20 minutes a day will not improve hemoglobin A1c levels in most type 2 diabetics.  We can assume blood sugars aren’t lower either.  It takes a combination of both types of exercise to lower hemoglobin A1c.

A hundred and forty minutes of exercise weekly—just 20 minutes a day—is not too much to ask for, if improved health and weight management are the goals.  More would be better.

Over nine months, the control group ended up needing more diabetic drugs.  The combination training group decreased its drug use.

Dr. Bernstein may still by right to stress resistance training over aerobic.  I bet he’d say these folks weren’t exercising enough.  The study at hand suggests that it’s important to do both types of exercise, especially if you’re not going to put much time into it.

The details of the resistance training program are probably important.  You can read the study yourself and decide if participants were on a good regimen.  I’ve little expertise in that area. 

ResearchBlogging.orgDiabetics taking insulin, sulfonylureas, and meglitinides are at risk for hypoglycemia during exercise. The study authors made little mention of this, so it may be safe to assume it wasn’t a problem. Certified diabetes educators saw participants monthly, which may have nipped the problem in the bud.

Steve Parker, M.D.

Reference: Church, T., Blair, S., Cocreham, S., Johannsen, N., Johnson, W., Kramer, K., Mikus, C., Myers, V., Nauta, M., Rodarte, R., Sparks, L., Thompson, A., & Earnest, C. (2010). Effects of Aerobic and Resistance Training on Hemoglobin A1c Levels in Patients With Type 2 Diabetes: A Randomized Controlled Trial JAMA: The Journal of the American Medical Association, 304 (20), 2253-2262 DOI: 10.1001/jama.2010.1710

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