There is currently sufficient scientific evidence to assert that strength training is an effective method for preventing, treating and potentially reversing various chronic diseases. Indeed, adherence to a properly designed strength training program can significantly increase the physical and mental health of the population.
The importance is such that several world-renowned organizations (World Health Organization, Centers for Disease Control and Prevention, American Heart Association, American Association for Cardiovascular and Pulmonary Rehabilitation, American College of Sports Medicine) recommend this form of training for maintain health.
However, despite this evidence, most of exercise recommendations are still for aerobic training, and few physicians (and health professionals in general) recommend strength training. This article aims to alert for the relevance and valuable impact of strength training on health.
About 100% of our biological existence has been dominated by outdoor activity. Hunting and searching for food has been a condition of human life for millions of years1. That is, if in the past it took effort (i.e. physical activity) to find food, nowadays food comes to us without having to make any effort. Therefore, we have moved from a very active lifestyle to a highly sedentary lifestyle. With serious consequences for public health. If in the past all people had to engage in some sort of physical exertion to carry out their daily tasks, today most of them do not have those needs. The environment has changed and so have people. They are weaker, sicker, have more chronic pain and are increasingly dependent on medicines. But the message still going on in our society (and passed on in medical appointments) is “make no physical efforts and follow your normal life”. And I believe this is the worst advice people can get! Normal life? But what kind of advice is this? How can normal be good? You must be completely alienated from reality in order to make such recommendations.
Today we have more opportunities than ever to build a healthy and strong phenotype. The phenotype is the expression of our organism, and it depends largely on the choices we make every day. Two organisms can have the same genotype, the same DNA, but different phenotypes – based on their experiences and the environment. Admittedly, there are things we cannot control such as our genetic heritage, the place of the world where we were born / lived, overall luck and the general environment to some extent. But there are many things that we can control that depend solely on our priorities in life and our daily choices (examples: exercise habits, eating, sleeping, stress management, smoking, alcohol, exposure to polluted environments). And I believe that exercise in general (and strength training in particular) is the most important factor of all. It is the most potent, it’s quantifiable and acts quickly on all systems and organs of the human body.
The reality is this: the population is aging and with more chronic / noncommunicable diseases. The main noncommunicable diseases are cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. These four disease groups alone account for over 80% of the 41 million deaths in the world2! According to the first report on healthy aging by the World Health Organization (WHO), the number of people over 60 is expected to double by 20503, and it is in this context that we need to urgently intervene to promote motor autonomy and improve people’s functional capacity. Traditional recommendations for walking, swimming, Pilates, and “doing low effort activities” or “no physical effort” probably need to be reconsidered and properly contextualized.
It is in this context that strength training and athletic training play a key role. All people (athletes and non-athletes) need to train their physical qualities to live with quality and independently. After age 30, adults lose 3-8% of their muscle mass per decade. Over time, the loss of lean mass contributes to a decrease in muscle strength and power, which are important predictors of balance, falls and mortality4. In the case of the elderly, it is important to note that falls are the main cause of accidental death after age 65 and hip fractures are those that most affect their independence5.
When I speak of strength I mean the basis for interacting with the environment around us, the foundation for the development of other physical qualities (mobility, power, speed, agility, muscle endurance), the ability to produce strength against external resistance (it can be the floor or any other object) through muscle contractions. This is probably the most trainable capacity we have and the one that could have the greatest impact on improving our function, independence and functional longevity. Tasks such as brisk walking, sitting and rising from a chair, climbing stairs, maintaining balance, carrying luggage, or playing with children / grandchildren are examples of activities in our daily lives that require a minimal component of various manifestations of strength (maximum strength, power and strength endurance). Therefore, both strength and muscle (quality rather than quantity) are physical function related parameters that need to be taken care of in the quest for achieving a healthy aging phenotype.
These issues are even more important when we note that as of 1st of October 2016, in the tenth revision of the International Classification of Diseases (ICD-10), sarcopenia has been classified as a disease by WHO and has its own code (M62.84). This should lead to increased availability of diagnostic tools and increased enthusiasm for the pharmaceutical industry to develop drugs to combat sarcopenia6. But in my opinion, this also represents a great opportunity for exercise professionals to be able to help fighting this disease, as strength training (properly oriented of course) will be the most potent stimulus in its prevention and treatment.
- Booth FW, Roberts CK, Laye MJ. Lack of exercise is a major cause of chronic diseases. Comprehensive Physiology. 2012;2(2):1143-1211. doi:10.1002/cphy.c110025.
- GBD 2015 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet, 2016; 388(10053):1659-1724.
- Beard JR, Officer A, de Carvalho IA, et al. The world report on ageing and health: A policy framework for healthy ageing. Lancet 2016;387:2145e2154.
- English KL, Paddon-Jones D. Protecting muscle mass and function in older adults during bed rest. Current Opinion in Clinical Nutrition and Metabolic Care. 2010;13(1):34-39. doi:10.1097/MCO.0b013e328333aa66.
- National Center for Injury Prevention and Control of the Centers for Disease Control and Prevention. Preventing Falls: A Guide to Implementing Effective Community-Based Fall Prevention Programs 2nd edition. Atlanta: 2015.
- Anker SD, Morley JE, von Haehling S. Welcome to the ICD-10 code for sarcopenia. J Cachexia Sarcopenia Muscle. 2016 Dec;7(5):512-514. Epub 2016 Oct 17. PubMed PMID: 27891296; PubMed Central PMCID: PMC5114626.