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Exercise 5: the recommendation to do strengthening exercises

This post is also downloadable as a Word format handout. 

I blogged a couple of weeks ago on "Exercise 3: US Department of Health & Human Services, resources for assessment & advice" and quoted the fine 2008 "Physical activity guidelines for Americans" with its recommendation that - besides regular aerobic exercise - "People are encouraged - on at least two days per week - to strengthen the major muscle groups involving legs, hips, back, chest, stomach and shoulders.  Exercises for each muscle group should be repeated for 8 to 12 repetitions per session."

I wanted to write about what specific exercises one might do to strengthen these major muscle groups but - before I do - I would also like to comment on a research finding that isn't that widely known.  Many, maybe most, people know that aerobic exercise reduces mortality risk to a large extent because it helps keep our hearts in good shape.  How many people know that increased muscular strength is also - and independently from aerobic fitness - associated with reduced risk of death?  So back in 2002 Tanasescu et al reported that "Men who ran for an hour or more per week had a 42% risk reduction (cardiovascular) compared with men who did not run. Men who trained with weights for 30 minutes or more per week had a 23% risk reduction compared with men who did not train with weights."  Buchman et al, looking at an older population, found that muscular strength was associated with reduced all cause mortality and commented "These results were similar when men and women were analyzed separately."  More recently still, in a large study following over 8,000 men, Ruiz & colleagues reported "Muscular strength is inversely and independently associated with death from all causes and cancer in men, even after adjusting for cardiorespiratory fitness and other potential confounders." and in a still more recent paper focusing on cancer they found "Higher levels of muscular strength are associated with lower cancer mortality risk in men, independent of clinically established measures of overall and central adiposity, and other potential confounders." 

Fascinating.  In his 2006 paper "The underappreciated role of muscle in health and disease", Wolfe writes technically but interestingly "Muscle plays a central role in whole-body protein metabolism by serving as the principal reservoir for amino acids to maintain protein synthesis in vital tissues and organs in the absence of amino acid absorption from the gut and by providing hepatic gluconeogenic precursors. Furthermore, altered muscle metabolism plays a key role in the genesis, and therefore the prevention, of many common pathologic conditions and chronic diseases."  Muscle tissue is good for our bodies metabolically and also it simply helps us function better.  See for example Rantanen et al's study "Midlife hand grip strength as a predictor of old age disability" or O'Reilly et al's "Quadriceps weakness in knee osteoarthritis: the effect on pain and disability" or Young & Dinan's report that "Even healthy elderly people lose strength at a rate of some 1-2% a year and power at a rate of some 3-4% a year ... The resulting weakness has important functional consequences for the performance of everyday activities. In the English National Fitness Survey, nearly half of women and 15% of men aged 70-74 years had a power to weight ratio (for extension of the lower limb) too low to be confident of being able to mount a 30 cm step without a hand rail."

Besides effects of strength on mortality risk and daily functioning, it's well worth noting that strength training seems (on current evidence) to be as effective as stamina training for treatment and prevention of stress, depression and other psychological symptoms.  The recent "SIGN guidance on non-pharmaceutical management of depression" is clearly positive about the benefits of exercise and specifically mentions both aerobic (e.g. walking & jogging) and anaerobic (e.g. weight training) forms.

Being aware of this kind of research emphasises the good sense in following the 2008 US guideline's recommendation " ... on at least two days per week ... strengthen the major muscle groups involving legs, hips, back, chest, stomach and shoulders.  Exercises for each muscle group should be repeated for 8 to 12 repetitions per session."  But what exercises should one use to do this?  If you want to be really technical, you can have a look at the freely downloadable "position stand" from the American College of Sports Medicine (ACSM) "Progression Models in Resistance Training for Healthy Adults".  They also produce a series of books - for example "ACSM's guidelines for exercise testing and prescription".

For a more readily practical book on muscle strengthening, it's easy to get lost amongst the choices.  Searching, for example at Amazon, yields pages & pages of different books.  I'm not an expert here.  Of the several choices that look pretty good, I would highlight Murphy's "The body you want in the time you have".  He gives a series of twice weekly options (many would be suitable for both men & women) and which would be even quicker to do if one follows the US guideline's suggestion of only doing 8 to 12 reps per session.  Also worth considering are Delavier's "Strength training anatomy", and Pagano's "Strength training for women".  I'm sure many of the other options are also excellent.  If you want books on stretching as well, Walker's "The anatomy of stretching" looks good, and I notice an old favourite of mine - Anderson's "Stretching" - is coming out in a new edition soon.


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