Benefits of Resistance Training on Later Life

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What recent evidence is there that encouraging adults to participate in resistance training can add to a healthy and long life?

‘Resistance training (RT) was originated in the 1945 publication of Captain Thomas DE Lorme but was first recognised in the American College of Sports Medicine in 1990.  It promotes anabolism and thus promotes muscle growth through the synthesis of new muscle proteins and also preserves existing proteins.’ Human Kenetics, Physical Activity and Health 2nd Edition, William L.Haskell 2012.

RT is a moderte to vigorous  form of exercise, moderate is defined as being able to work hard enough to raise a heart rate and break a sweat, whilst being able to carry on a conversation and is defined as between 40-60% of functional capacity or 40-60% VO2 max. Vigorous Exercise is defined as >60% full capacity or VO2 max and unable to carry out a conversation.

Heart rate (beats per minute) increases as VO2 Max increases

ACSM 2010

The 2018 recommended guidelines for physical activity have been ‘150-300 minutes per week of moderate intensity activity and 75-100 minutes of vigorous activity’. (ACSM’s Health & Fitness Journal:January/February 2019 www.acsm.org)

To discover the measurement of exercise intensity ‘Metabolic Equivalent of Task’ (MET) can be used, one MET equals the volume of oxygen consumed whilst at rest. ‘The average individual will consume approximately 3.5ml of oxygen per kilogram of their body mass.  This is the equivalent to 1.0 MET thus the energy expenditure is 1.0 MET.  (Willmore and Costil, 2004).  An increase in activity will lead to elevated oxygen levels and consumption and as a result the oxygen level will increase.

In early stages the majority of performance improves are likely to be the result of changes in the way the nervous system controls and co-ordinates movement (Earle & Baechle, 2004) When we perform an activity our senses provide constant feedback from limb position, force generation and performance outcome (a successful movement)  regular practice causes adaptation in the central nervous system results in greater control of movement, becoming smoother and more accurate. 

The current American College of Sports Medicine (guidelines for resistant training are shown in the table below:

Adults (18-64)

Older Adults >65

Frequency

Each muscle group 2-3 x a week

Each muscle group 2-3 times per week

Intensity

60-80% 1 rep max (RM)

Volition fatigue (not to failure)

5-6 on the 10 point Rate per exercise scale

Or 40-50% 1RM for beginners

Time

2-4 sets

18-12 reps per set

10-15 reps per set

2 sets

Type

Concentric, eccentric, isometric, isokinetic

resistance bands

weight lifting

Body weight exercises

Rest

48 hours between sessions

48 hours between sessions

Progression

Increase intensity to maintain

Increase Intensity to 8-12 reps per set

*Rate per exercise scale is a scale used to discover the level of intensity 1 being easy 10 being hard.

(Wayne Wescott PhD, CSCS, 2009).

I have designed a programme using these guidelines for a client I trained as a personal trainer over 6 months.  I have included exercises to train all muscle groups, she is in between a beginners – intermediate level of training ability. Her profile is:

  • Female
  • 23 years of age
  • 42.1% body fat % at start of programme
  • 153 lbs
  • Height 5.3 feet

(Appendix 1)

Although it still remains unclear for trained individuals. ‘A study of programme design for hypertrophy and muscle insurance performed over eight weeks by 34 men, experienced in RTshowed that a total duration of a 39 minute duration spread over a week period was just as effective as training five times as long.

Three groups divided into one, three or five sets who performed seven exercises covering all large muscle groups  (to muscle failure) , all for 8-12 reps and where for three times a week on non-consecutive days.

Results of one repetition maximum strength testing showed that all groups significantly increased strength from baseline in the bench press (6.1% to 9.7%) and back squat (11.9% to 18.3%) exercises, with no significant differences found between the groups.

ACSM’s Health & Fitness Journal:January/February 2019 www.acsm.org

One of the most noticeable changes is age related decrease in muscle-mass, sarcopenia, this is due to a gradual loss of androgenic hormones (testosterone), together with decreased neuromotor stimulation and protein metabolism. These hormones peak in young adult men and then lower at a rate of 1% per year from the age of 30.

As we age we loose brain cells including motor-neurons that signal our muscles to contract.  The decrease in neuromotor stimulation tends to affect fast-twitch muscles the most, these are used in RT.  Muscle mass is a good predictor of mortality and so RT is a key factor in fighting the age-process.

 The heart can develop problems when we age as muscles can become weaker if exercise levels are reduced as a result valves can become less efficient and the electric conduction system can cause arrhythmias, the heart tissue can become scarred with ischemia and infarctions and the colanary arteries supplying blood and oxygen to the heart can become hardened and narrowed with arteriosclerosis.

Bones lose mineral density making them weaker, cartilage is lost in our joints causing arthritis and joint pain, spurs grow in peoples joints and joint capsules resulting in loss of flexibility, also invertrable disc loose height making the spine shorter and stiffer. Major causes of disability are:

  • Arthritis
  • Injuries and fractures
  • Lowered range-of-motion
  • Pinched nerves from spine diseases

These can all limit participation in exercise, but RT is still possible to perform and is beneficial for bone and joint health. (LeMond & Hom, n.d.)

The recommended guidelines for Americans for the period of 2008-2018 For adults the implementations helped to lower the risk of all cause mortality.  In addition, the 2018 Physical Activity Guidelines Committee Scientific Report provides new insight since their last report in 2008 and ‘focus on the causes:

  1. Aging
  2. Brian Health
  3. Cancer primarily prevention
  4. Cardiometabolic health and prevention of weight gain
  5. Exposure
  6. Individuals with chronic conditions
  7. Promoting regular physical activity
  8. Sedentary behaviour
  9. Youth as well as a pregnancy working group’

Leading Cause of Death and Most Prevalent Conditions for Which Greater participation in Physical Activity Would Be Expected to Reduce Incidence and health benefits

 

Ten leading causes of death

Ten most prevalent

1

Heart disease

Hypertension

Reduced risk of progression of cardiovascular disease

Reduced risk of increased blood pressure over time

2

Cancer

Risk of mortality

Hyperlipidaemia

3

Chronic lung diseases

Upper raspatory conditions

4

Unintentional Injuries

Falls – improved walking, balance and activities of daily living

Arthritis

Decreased pain

Improved function and quality of life

5

Stroke

Improved walking, balance and activities of daily living

Mood disorders

Improved cognition, memory, process speeds, attention.

Enhanced quality of sleep

Reduced risk of depression

6

Alzheimer’s disease

Cognitive performance

Diabetes

Type 2 –

reduced risk of cardiovascular mortality

reduced progression of disease indicators: haemoglobin A1c, blood pressure, blood lipids and BMI

7

Diabetes

Type 2 –

reduced risk of cardiovascular mortality

reduced progression of disease indicators: haemoglobin A1c, blood pressure, blood lipids and BMI

Anxiety disorders

Improved cognition, memory, process speeds, attention.

8

Influenza and pneumonia

Asthma

9

Kidney disease

Coronary artery disease

10

Suicide

Thyroid disorders

*Conditions shaded in blue are favourably influenced by greater participation in regular physical activity. (Kenneth Powell, Abby C King, David M. Buchner, Wayne W. Campbell, Loretta DiPietro  Kirk L Erikson, Charles H Hillman, John M Jakicic, Kathleen F. Janz, Peter T Katzmarzyk, William E. Kraus , Richard F. Mackro, David X Marquez, Anne McTiernan, January 2019.)

Obesity is a disease where excess body fat has built up to such an extent that it has an adverse effect on health, the consequences can vary between individuals.  Each individual has a different body type and therefor fat can be distributed differently

Obesity is worldwide issue and it is outcome of poor diet and physical inactivity health causing a lot of health consequences.  It is due to a chronic energy imbalance where intake of food exceeds expenditure. Overwight issues and obesity is more that a feminist issue. (Hardman et al. 2009).

Obesity, or excessive body fat, is linked to Type 2 Diabetes mellitus (T2DM) via insulin resistance.  The benefit of exercise of glucose tolerance thought to be due, in part, to improvements in insuline sensitivity. (Hardman,, A., E. and Stensel, D., J., 2009).  An effect of this has been found in just one single session of RT (Koopman et al. 2005).

Body Mass Index is used to measure the overall amount of body fat but on some individuals a skin fold measurement can be taken by pinching the skin with callipers which when calculated provides a percentage of body fat overall and for each individual area tested i.e. by using‘ 4 sites:

  1. Biceps
  2. Triceps
  3. Subscapular
  4. Suprailiac‘

(Durnin and Wormersley 1974)

Diabetes is the most common endocrine disorder and effects all over the body and can cause renal failure, nerve damage, heart disease and stroke, also blindness.  This is because the body can no longer control the level of circulating blood glucose.

Type 1 diabetes is where the cells which produce insuline are mistakenly recognised by the immune system.

In type 2 Diabetes is mainly a metabolic disorder in which insulin level rise. It has been found that ‚a moderate intensity level of aerobic exercise encourporating all muscle groups has been shown to reduce insuline sensetivity particularly within the muscle tissue ( Erikson 1999).

Cardiovascular diseases (CVD) is a group of disorders of the heart and blood vessels

  • Hypertension
  • CHD (ischemic heart disease) including angina, myocardial infarction (heart attack)
  • Stroke
  • Peripheral heart disease
  • Heart failure
  • Rheumatic heart disease
  • Cardiomyopathies

A study found a link between sedentary behaviour and mortality caused by CVD thus linking physical activity to improving the risk of prevention. European Journal of Epidemiology  (Richard Patterson, Eoin McNamara, Marko Tainio, Thiago Hérick de Sá, Andrea D. Smith, Stephen J. Sharp, Phil Edwards, James Woodcock, Søren Brage, Katrien Wijndaele, 2018)

Hypertension (high blood pressure) is one of the most common diseases found across the world in among all age groups.   The result of 2 month study where 30 hypertensive patients engaged in physical activity (aged between 25-45 years) provided reduction in systolic and diastolic pressure was 3.33 mmHg and 3.2mmH. Significantly reduced the blood pressure without any intake of blood pressure reducing pills. (Jitesh et al. 2016).

 it is now widely accepted that people do not undertake enough PA. Globally, around 23% of people were not active enough in 2010 (World Health Organization (WHO, 2017WHO. (2017). 

In the case of Europe, in 2013 59% of Europeans reported that they never or seldom participated in PA (European Commission, 2014bEuropean Commission. (2014b). Eurobarometer 80.2 (2013). TNS Opinion [producer]. GESIS Data Archive, Cologne. ZA5877 Data file Version 1.0.0, doi:10.4232/1.12010 [Google Scholar]). 

The results of the study using over 28 European Union Member States, using a cohort of 297,919 people >15 years of age and conducted using the  Eurobarometer 80.2 to explore a correlation or differences in  individual participation in sports and PA from (European Commission, 2014bEuropean Commission. (2014b). Eurobarometer 80.2 (2013). TNS Opinion [producer]. GESIS Data Archive, Cologne. ZA5877 Data file Version 1.0.0, doi:10.4232/1.12010 [Google Scholar]).

It showed that there was a link to a regional approach and regional coordination at the EU level for boosting PA and sports participation as a way to reduce regional disparities and promote health-enhancing PA.  Indicating that there in the countries where PA is heavily promoted there are more participants.

‘The Nordic countries and the Netherlands are the most physically active countries, the Southern countries and the new Member States being less active (Gerovasili, Agaku, Vardavas, & Filippidis, 2015.) and (Kornbeck, 2013Kornbeck, J. 2013). 

The national Health Service (NHS) in England have announced their ‘Long Term Plan’ and aims to ‘tackle major killer conditions and save up to half a millions lives’ and states it will ‘help to prevent 150,000 heart attacks, strokes and dementia cases’ also ‘>three million people will improve by new and improved stroke, raspatory and cardiac services.’ Also it is set out to be the ‘biggest investment in mental health’ and ‘will see around >two million people who suffer with anxiety, depression or other problems.’ In its mission statement is also states and will also launch a Diabetes Prevention Programme.’ (NHS England chief executive Simon Stevens, 07/01/2019)

NHS Long Term Plan to tackle major killer conditions and save up to half a million lives, blog, (www.longtermplan.nhs.uk, 2019).

A U.K. government has employed Sport For England’s (SFE) and has developed the ‘Active Nation Campaign’ in line with ‘Sporting Future: A New Strategy for an Active Nation’ it  highlights the need to address that ‘1 in 6 deaths in the U.K. are due to inactivity’ and is targeted at not only people who already engage in sport and physical activity but is designed to influence and motivate individuals who have not previously had involvement.  SFE has approached this since 2013 and works in partnership with mental health charity, Mind and has got’ over 36,000 inactive people taking part’, their research shows of which, where continuously engaging 3 months post initial engagement.  It has also found that ‘48% of inactive adults want to take part in exercise.’ (Active People Survey Apr 2014-March 2015, Adult Active Lives Survey 2017.

SFE has continued their on-going focus on groups who have been found not to typically take part in physical activity:

  • Women
  • Elderly
  • Disabled
  • Lower Soci-economical.

(HM Government, Sporting Future: A New Strategy for an Active Nation’ December 2015)

Fitness Trends and their popularity through word of mouth encourages participation in exercise. ‘Yoga is recommended in multiple studies as having a large number of health benefits such as decreased depression and anxiety, decreased lower back pain and improved flexibility and balance.’ (Yoke, Mary, Ph.D., FACSM, M.A., M.M. 2019).

Mental Illness is the fourth leading cause of disability worldwide and is predicted to be the second leading cause in developed countries by 2020. (World Health Organization, WHO).

‘Yoga has featured in the top 10 exercise trends since 2007 and is viewed highly by fitness professionals and is just one type of RT which has featured as a trend since 2009; the other trends being:

  • Strength
  • Core
  • Body Weight
  • Functional Fitness ‘

Making a lifestyle choice to include RT throughout adulthood can slow down the ageing process and prevent health conditions from occurring as well as decreasing the risk of making current conditions worse and/or developing additional conditions as a result of in-activity. It is important to follow a bespoke programme if an individual has a diagnosed health condition and to determine if RT can be included and at which level.  More recent studies have found that RT mainly has a positive effect in longevity of adults thus decreasing the mortality rate in older adults.

Bibliography

  • Baechle, T. R., & Earle, R. W. (Eds.). (2004). NSCA’s Essentials of Personal Training. Champaign, IL: Human Kinetics.doi: 10.1249/FIT.0000000000000427
  • Erikson 1999 Exercise and treatment of type 2 diabetes mellitus.  An update. Sports Medicine 27 6, 318-391 Features
  • Fernando Lera-López &Rocio Marco
  • Gerovasili, V., Agaku, I. T., Vardavas, C. I., & Filippidis, F. T. (2015). ACSM’s Health & Fitness Journal: January/February 2019 – Volume 23 – Issue 1 – p 31–33 doi: 10.1249/FIT.0000000000000445
  • Hardman,, A., E. and Stensel, D., J., (2009) Physical Activity and Health, 2nd edn., Taylor & Francis e-Library, Routledge

         Howley, Edward T., Ph.D., FACSM ACSM’s TOP 10 FITNESS TRENDS,What’s Hot and What’s Not,A Look Back, ACSM’s Health & Fitness Journal: November/December 2018 – Volume 22 – Issue 6 – p 18–23

  • Jitesh, S., Devi, G. (2016) ´Effect Of Zumba Dance On Blood Pressure ´, Journal of Pharmaceutical Sciences and Research, vol. 8(6), pp. 501-505, doi: 1808004187
  • Kenneth Powell, Abby C King, David M. Buchner, Wayne W. Campbell, Loretta DiPietro  Kirk L Erikson, Charles H Hillman, John M Jakicic, Kathleen F. Janz, Peter T Katzmarzyk, William E. Kraus , Richard F. Mackro, David X Marquez, Anne McTiernan, Journal of Physical Activity and Health Vl. 16, Issue 1 Pages 1-11 January 2019, The Scientific Foundation for the Physical Activity Guidelines for Americans, 2nd Edition
  • Koopman et al. 2005 (European Commission, 2014bEuropean Commission. (2014b). Eurobarometer 80.2 (2013). TNS Opinion [producer]. GESIS Data Archive, Cologne. ZA5877 Data file Version 1.0.0, doi:10.4232/1.12010 [Google Scholar]).
  • LeMond, G., & Hom, MThe science of fitness. The science of fitness, power, performance and endurance 2015 Pages 107-116
  • NHS England chief executive Simon Stevens NHS Long Term Plan to tackle major killer conditions and save up to half a million lives, blog, www.longtermplan.nhs.uk, , 07/01/2019

         NHS England chief executive Simon Stevens, 07/01/2019, NHS Long Term Plan to tackle major killer conditions and save up to half a million lives, blog, www.longtermplan.nhs.uk

  • Pages 1784-1791, 2017
  • Richard Patterson, Eoin McNamara, Marko Tainio, Thiago Hérick de Sá, Andrea D. Smith, Stephen J. Sharp, Phil Edwards, James Woodcock, Søren Brage, Katrien Wijndaele European Journal of Epidemiology  (, 2018)
  • Rt Hon David Cameron Prime Minister Tracey Crouch MP, Minister for Sport, Tourism and Heritage  (at the date of the report) (HM Government, Sporting Future: A New Strategy for an Active Nation’ December 2015
  • Wayne Wescott PhD, CSCS, 2009) ACSM Strength Training Guidelines, Role in Body Composition and Health Enhancement
  • William L.Haskell, Human Kinetics, Physical Activity and Health 2nd Edition, 2012
  • Willmore and Costil, 2004.  Physiology of Sport and Exercise Champaign III, Human Kinetics,
  • www.sportengland.org Active People Survey Apr 2014-March 2015, Adult Active Lives Survey 2017

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