Nutrition
CREATINE FOR ALL!

 

The International Society of Sports Nutrition published in 2017 a position stand (see reference below) on the safety and efficacy of creatine supplementation in the context of exercise, sports and medicine.

Creatine supplementation, one of the most popular and studied nutritional supplements, has in fact been shown to be effective in improving athletic performance (especially in high intensity exercise) and inducing relevant training adaptations. The consequent increase in intramuscular creatine (and phosphocreatine) reserves facilitates the rapid re-synthesis of ATP, the so-called energy “currency” of the body, which is essential for almost every reaction in our body. Thus, the increased availability of creatine in the cell through supplementation contributes to improve performance because it increases the energy availability in order to exercise (i.e. muscle contraction) as well as a whole range of other muscle cell related reactions. Creatine supplementation can in fact enhance strength production, muscle work, accelerate recovery and help preventing injury.

Additionally, creatine supplementation appears to be highly safe and effective not only in athletes but also in non-athletes (such as the so-called exercise enthusiasts), as well as in various clinical populations. In fact, several studies (see ISSN article, reference below) point to benefits of creatine supplementation in various populations and clinical settings, such as:

– Accelerating injury rehabilitation (because it attenuates muscle atrophy);

– Protection of neuronal injuries (spinal and cerebral);

– Mitigation of debilitating consequences in people with congenital syndromes of creatine synthesis deficiency;

– Attenuating the progression of neurodegenerative diseases (e.g. Huntington’s disease, disease, Parkinson’s disease, mitochondrial diseases, amyotrophic lateral sclerosis);

– Prevention and / or improvement of bioenergetics in patients with myocardial ischemia or stroke victims;

– Improving metabolic and functional indicators associated with aging;

– Possible benefit during pregnancy for optimal growth, development and health of the fetus.

In conclusion, creatine does indeed appear to be a safe and beneficial nutritional supplement for a wide range of populations and ages. Indeed, this is a supplement that actually works!

Take creatine and power to you!

Nuno Correia

References:

Kreider, R.B. et al., 2017. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. Journal of the International Society of Sports Nutrition, 14(1), p.18. Available at: http://jissn.biomedcentral.com/articles/10.1186/s12970-017-0173-z.

Physical Training
IT IS WRONG TO THINK THAT THE LACK OF STRENGTH IS NOT A HEALTH PROBLEM – PART 2

 

“People don’t decide their future, people decide their habits and their habits decide their future.”

– F.M. Alexander

Nine years ago (2010)1, the European Working Group on Sarcopenia in Older People (EWGSOP) published a definition of sarcopenia that has been widely used worldwide and this definition has fostered advances in the identification and care of people at risk or with sarcopenia. It was defined as a syndrome characterized by progressive and widespread loss of muscle mass and strength at risk of adverse outcomes such as physical disability, poor quality of life and death. Because the relationship between muscle mass and strength is not linear (the ability to generate strength is not only dependent of muscle mass), the criteria for its diagnosis included low muscle mass and low muscle function (i.e. strength or physical performance).

After learning that in 2016 sarcopenia was classified as a disease by the World Health Organization, as noted in the first part of this article, the EWGSOP22 updated its operational definition and various diagnostic strategies, considering now that muscle strength (measured by grip strength or the chair stand test) is the main parameter for measuring muscle function, even more important than the amount of muscle mass. Therefore, it is in this context that we justify the title of this article and reinforce the importance of sharing this message with all health professionals.

The implications of this condition on human health are several and widely known: increased risk of falls and fractures3,4; impairment of activities of daily living5; association with heart disease6; respiratory disease7 and cognitive dysfunction8; lower quality of life9; loss of independence10,11,12 and death13. In financial terms, public health costs have also been calculated in several papers. In a study by Janssen et. al.14, in 2004, the costs of sarcopenia in the United States were estimated at $ 18.5 billion annually, representing about 1.5% of total health costs. In a study conducted here in Portugal at the Hospital de Santo António in Porto and published in 201615, it was found that hospitalization costs associated with sarcopenia were higher by 58.5% for patients under 65 years and by 34% for patients aged 65 and over. More recently (2018), the Hertfordshire Cohort Study in the United Kingdom16 found that the costs associated with lack of muscle strength were estimated at £ 2.5 billion annually.

In the present scenario, where the phenotype of unhealthy aging is proliferating in the eyes of all industrialized nations, in which diseases such as hypertension, cancer, depression, Alzheimer’s disease and type II diabetes are destroying people’s lives, it is essential to adopt measures aimed at improving function of each individual rather than diagnosing illnesses and administering medicines which, in addition, do not help solving this problem, and may further aggravate their condition. We know that the main health problems are related to poor diet, physical inactivity, lack of sleep, excess alcohol, exposure to tobacco and polluted environments but also lack of movement quality, vigor and muscular strength.

The benefits of strength training in health are well supported in the scientific literature and the most important ones are: decrease in blood pressure; decreased risk of osteoporosis and sarcopenia; improvement of lipid profile; increased cardiorespiratory capacity; prevention and management of chronic pain; increased insulin sensitivity; improvement of wellbeing and self-confidence. Moreover, several studies17,18,19 have shown a strong and consistent correlation between increased strength and muscle mass with decreased mortality, reinforcing the fact that the decline in strength associated with the current levels of sedentarism and aging need to be addressed. Therefore, a well-designed strength training program that meets the individual’s competency and follows the principles of adaptation to training will improve all of the above health indicators and all the necessary physical qualities (strength, power, speed, agility, balance, coordination, mobility, endurance) to carry out the activities of our daily life. These are the parameters of physical function that are currently being proposed as biomarkers of aging in humans20.

Consequently, program design will be the determining factor in this equation. And while it is true that this process requires imperative knowledge of sports sciences, it must be borne in mind that it also requires field work and art in coaching. Instead of being so preoccupied with following the guidelines and looking for statistically significant results, we should be concerned that our approach is relevant to one’s life. Because we work with people. People who have time constraints to train. People with different family and professional responsibilities. People who have different lives from each other. People who have a host of metabolic and / or orthopedic problems that no randomized controlled trial can ever reproduce! Yes, this is a complex process.

Finally, we know that one of the mechanisms responsible for muscle atrophy, sarcopenia and aging is apoptosis, a form of programmed cell death and a fundamental process in aging. But when we train, eat and rest properly, we are sending a signal to our body to create an anabolic environment, an environment that enhances the release of growth factors and suppresses apoptosis. That is, strength training is a macroscopic growth factor that suppresses programmed cell death (i.e. apoptosis), but unlike drugs, where an increasing in dose means more disease and dependence, an increase in load (even if reduced) means more health, more strength and more vigor. This way, the daily decisions will always be up to each one: treat the body like a Ferrari or treat the body like a rental car.

Pedro Correia

References:

  1. Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al. Sarcopenia: European consensus on definition and diagnosis: report of the European working group on sarcopenia in older people. Age Ageing 2010; 39: 412–23.
  2. Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, Cooper C, Landi F, Rolland Y, Sayer AA, Schneider SM, Sieber CC, Topinkova E, Vandewoude M, Visser M, Zamboni M; Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019 Jan 1;48(1):16-31.
  3. Bischoff-Ferrari HA, Orav JE, Kanis JA et al. Comparative performance of current definitions of sarcopenia against the prospective incidence of falls among community-dwelling seniors age 65 and older. Osteoporos Int 2015; 26:2793–802.
  4. Schaap LA, van Schoor NM, Lips P et al. Associations of sarcopenia definitions, and their components, with the incidence of recurrent falling and fractures: the longitudinal aging study Amsterdam. J Gerontol A Biol Sci Med Sci 2018; 73: 1199–204.
  5. Malmstrom TK, Miller DK, Simonsick EM et al. SARC-F: a symptom score to predict persons with sarcopenia at risk for poor functional outcomes. J Cachexia Sarcopenia Muscle 2016; 7: 28–36.
  6. Bahat G, Ilhan B. Sarcopenia and the cardiometabolic syndrome: a narrative review. Eur Geriatr Med 2016; 6: 220–23.
  7. Bone AE, Hepgul N, Kon S et al. Sarcopenia and frailty in chronic respiratory disease. Chron Respir Dis 2017; 14: 85–99.
  8. Chang KV, Hsu TH, Wu WT et al. Association between sarcopenia and cognitive impairment: a systematic review and metaanalysis. J Am Med Dir Assoc 2016; 17: 1164.e7–64.e15.
  9. Beaudart C, Biver E, Reginster JY et al. Validation of the SarQoL(R), a specific health-related quality of life questionnaire for Sarcopenia. J Cachexia Sarcopenia Muscle 2017; 8: 238–44.
  10. Dos Santos L, Cyrino ES, Antunes M et al. Sarcopenia and physical independence in older adults: the independent and synergic role of muscle mass and muscle function. J Cachexia Sarcopenia Muscle 2017; 8: 245–50.
  11. Akune T, Muraki S, Oka H et al. Incidence of certified need of care in the long-term care insurance system and its risk factors in the elderly of Japanese population-based cohorts: the ROAD study. Geriatr Gerontol Int 2014; 14: 695–701.
  12. Steffl M, Bohannon RW, Sontakova L et al. Relationship between sarcopenia and physical activity in older people: a systematic review and meta-analysis. Clin Interv Aging 2017; 12: 835–45.
  13. De Buyser SL, Petrovic M, Taes YE et al. Validation of the FNIH sarcopenia criteria and SOF frailty index as predictors of long-term mortality in ambulatory older men. Age Ageing 2016; 45: 602–8.
  14. Janssen I, Shepard DS, Katzmarzyk PT, Roubenoff R. The healthcare costs of sarcopenia in the United States. J Am Geriatr Soc. 2004 Jan;52(1):80-5.
  15. Sousa AS, Guerra RS, Fonseca I, Pichel F, Ferreira S, Amaral TF. Financial impact of sarcopenia on hospitalization costs. Eur J Clin Nutr. 2016 Sep;70(9):1046-51. doi: 10.1038/ejcn.2016.73. Epub 2016 May 11.
  16. Pinedo Villanueva, R. A., Westbury, L. D., Syddall, H. E., Sanchez, M., Dennison, E. M., Robinson, S. M., & Cooper, C. (2018). Health care costs associated with muscle weakness: a UK population-based estimate. Calcified Tissue International.
  17. Ruiz JR, Sui X, Lobelo F, et al. Association between muscular strength and mortality in men: prospective cohort study. BMJ. 2008;337(7661):a439. Published. doi:10.1136/bmj.a439.
  18. Srikanthan P, Karlamangla AS. Muscle mass index as a predictor of longevity in older adults. Am J Med. 2014;127(6):547-53.
  19. Dos Santos L, Cyrino ES, Antunes M, Santos DA, Sardinha LB. Changes in phase angle and body composition induced by resistance training in older women. Eur J Clin Nutr. 2016 Dec;70(12):1408-1413. doi: 10.1038/ejcn.2016.124. Epub 2016 Jul 13. PubMed PMID: 27406159.
  20. Cadore EL, Izquierdo M. Muscle Power Training: A Hallmark for Muscle Function Retaining in Frail Clinical Setting. J Am Med Dir Assoc. 2018 Mar;19(3):190-192.
Longevity, Physical Training
IT IS WRONG TO THINK THAT THE LACK OF STRENGTH IS NOT A HEALTH PROBLEM – PART 1

 

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.

Pedro Correia

 

References:

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
Physical Training
SHOULD WOMEN DO STRENGTH TRAINING?

 

Most women are afraid to lift weights like men because they think they will look bulky and like the women we see on the left hand pictures. It is time to demystify this idea and explain why this is impossible (provided than no hormones and/or anabolic steroids are used), and why strength training is key and a great ally to improve a number of parameters, including body composition.

Overuse of low-intensity training protocols by women is too common. Too much emphasis is placed on cardio, machine use, treadmills, bicycles, light loads, and too little emphasis is put on what will promote better physiological adaptations for increasing women’s functional capacity – strength training. If you want to bring more years into your life, you should start looking at strength training as one of the most effective anti-aging tools on Earth. There is no system in our body that is not influenced by strength training! Have I told you that it is cheaper than the creams you rub on your body every day?

I will divide this article into three parts. First, let’s highlight the myths of strength training for women, which were already addressed by Ebben & Jensen in 1998 in Strengthening for women: debunking myths that block opportunity. Second, let’s highlight its main benefits, and third, let’s explain why you will not look like Arnold Schwarzenegger.

1. MYTHS OF STRENGTH TRAINING FOR WOMEN

  •  Strength training will cause women to become big and heavy.The truth is that strength training helps to reduce body fat and increase lean mass. These changes may result in a slight increase in weight since the lean mass is more dense than fat (note: if this disturbs you throw the scale away and look more at yourself in the mirror!). Strength training will result in increased strength, no change or a decrease in the hip and waist perimeters and a slight increase in the perimeter of the upper body. Only women who are genetically predisposed for hypertrophy and who participate in high volume and intensity workouts may see substantial increases in the circumference of their limbs.
  • Women should use different training methods than men.Women are often encouraged to use machines and to do many repetitions slowly because they are afraid that the use of free weights, manual resistance, explosive movements or exercises that use their body weight as resistance will cause injury. In fact, there is no evidence suggesting that women are more likely than men to injure themselves during strength training. The most important factors to reduce the risk of injury are based on exercise technique and training individualization.
  • Women should avoid high intensity training or training with high loads.Women are usually encouraged to use smaller weights in their strength training (i.e., light dumbbells) but the problem is that these light loads are substantially below what is required to promote physiological adaptations. Women need to train at intensities high enough to promote adaptations in bones, muscles, cartilage, ligaments and tendons. When the intensity of the exercise is low, that is, when the stimulus is insufficient, the physiological benefits are minimal. To maximize the benefits of strength training, women should train close to their maximum. For women who have had children, imagine that this is what you have to “push” to get the greatest benefits.In short, there is no reason for women to train differently from men with regard to training intensity. If you intend to get different results, you need to leave aerobic classes and pink weights to start lifting real weights.

2. STRENGTH TRAINING BENEFITS FOR WOMEN

In addition to improving body composition (loss of fat mass and increase in lean body mass), strength training will help you:

  •  Increase bone remodeling. You will get stronger bones and reduce the risk of osteoporosis (LINK, LINK, LINK). Keep in mind that stronger bones can also result in total weight gain, but this is good, strong bones are a sign of health;
  • Strengthen the connective tissue. You will increase your joint stability and reduce the risk of injury (LINK). As in the previous point, same thing can happen regarding weight gain;
  • Increase functional strength for activities you enjoy or for your daily activities (e.g. playing with your kids, carrying grocery shopping, climbing stairs).
  • Increase self-esteem and confidence. A stronger body will make your mind stronger and unstoppable!
  • Fight the effects of metabolic syndrome and other common chronic diseases in our society, such as cardiovascular disease, type II diabetes, cancer, fibromyalgia, rheumatoid arthritis and Alzheimer’s disease (LINK, LINK).
  • Increase longevity in a healthy way. Strength training will potentiate the release of anabolic hormones that play an important role in tissue regeneration and anti- aging (LINK).

In summary, strength training has the potential to restore the shape of your glutes, the glow of your skin and the tonus of those parts of the body that you think is only possible through surgery, miracle supplements and advanced techniques of “muscle toning”. Strength training can also help you live the life of your dreams.

3. WHY I WILL NOT BECOME ARNOLD SCHWARZENEGGER?

arnold-schwarzenegger-6-claves-del-exito

 

Women have different physiological characteristics from men and this is the reason why women have greater difficulty in gaining muscle than men. As I said at the beginning of this article, if there are no hormones and/or anabolic steroids involved, it is very unlikely that women will look like men.

  •  Diferences in muscle fibersAlthough women have the same types of muscle fibers that men have (fast-twitch fibers and slow-twitch fibers), the amount of muscle fibers they have and their size is smaller. Remember that slow-twitch fibers (type I) are used primarily in endurance efforts whereas fast-twitch fibers (type II) are used primarily in rapid and explosive movements. In women, because they have 70-75% type I fibers, it becomes even more difficult to move loads at high speeds. This means that the potential for increasing the cross-sectional area of the muscle (i.e. muscle size) and for increasing the rate of force development is lower in females than in males.
  • Diferences in strength and powerThe average total body strength of a woman corresponds to about 60% of the average total body strength of a man. In average, upper body strength in women ranges from 25-55% of men’s upper body strength. Regarding lower body strength, it seems that women are stronger in relative terms. In average their capacity is 70-75% of what is observed in men. It is therefore not surprising that most women find it more difficult to lift weights with arms and upper body (e.g. push-ups and pull-ups) than with legs and lower body (e.g. squats and lunges).
  • Diferences in hormone levelsThe most obvious difference in the mechanisms that determine the adaptations to training of men and women is the sex hormone, testosterone. Both men and women produce testosterone, the difference is that testosterone concentrations in men are 10 to 20 times higher than in women! It appears that women are more dependent on pituitary secretion from growth hormone and other growth factors to help mediate changes in muscle, bone and connective tissue. In fact, although strength training adaptations do not occur in the same way, it has been reported that women have higher bioavailable concentrations of growth hormone at rest than men. Fortunately, strength training and metabolic resistance training can also increase growth hormone levels.Also, if you begin to lift weights in a progressive manner, you will continue to maintain your femininity, you will not grow a mustache, beard or hair in your chest. You will not get bigger or full of muscles. On the contrary, you will get leaner, stronger, younger, smarter and much more attractive to the opposite sex. But do not be fooled, to get the greatest benefits in training, you need to work hard and realize that it takes serious effort to induce the metabolic adaptations you seek (e.g. improving body composition and biological aging). This does not happen overnight. You will need time, consistency and discipline. There are no miracle pills.

In conclusion, before beginning a strength training program, be aware that you must have movement competency in the first place. Just as you would not begin to calculate derivatives in mathematics before you know how to add and subtract, it also makes no sense to start lifting heavy loads if you have restrictions and/or asymmetries in your movement profile. The quality of movement is the foundational support for functional strength development so this “ingredient” will always have to come first.

For a graphic resource check out this nice infographic from Positive Health Wellness.

See you soon and enjoy 🙂

Pedro Correia

References

Ciccolo Joseph T, Carr Lucas J, Krupel Katie L, Longval Jaime L. The Role of Resistance Training in the Prevention and Treatment of Chronic Disease. American Journal of Lifestyle Medicine July/August 2010 vol. 4 no. 4 293-308.

Cussler EC, Lohman TG, Going SB, Houtkooper LB, Metcalfe LL, Flint-Wagner HG, Harris RB, Teixeira PJ. Weight lifted in strength training predicts bone change in postmenopausal women. Med Sci Sports Exerc. 2003 Jan;35(1):10-7.

Ebben WP, Jensen RL. Strength training for women: debunking myths that block opportunity. Phys Sportsmed. 1998 May;26(5):86-97. doi: 10.3810/psm.1998.05.1020.

Hurley BF, Hanson ED, Sheaff AK. Strength training as a countermeasure to aging muscle and chronic disease. Sports Med. 2011 Apr 1;41(4):289-306. doi: 10.2165/11585920-000000000-00000.

Kraemer WJ, Ratamess NA. Hormonal responses and adaptations to resistance exercise and training. Sports Med. 2005;35(4):339-61.

Nickols-Richardson SM, Miller LE, Wootten DF, Ramp WK, Herbert WG. Concentric and eccentric isokinetic resistance training similarly increases muscular strength, fat-free soft tissue mass, and specific bone mineral measurements in young women. Osteoporos Int. 2007 Jun;18(6):789-96. Epub 2007 Jan 31.

Stone MH. Implications for connective tissue and bone alterations resulting from resistance exercise training. PubMed PMID: 3057317.

Winters KM, Snow CM. Detraining reverses positive effects of exercise on the musculoskeletal system in premenopausal women. J Bone Miner Res. 2000 Dec; 15(12):2495-503.

Zatsiorsky V., Kraemer, W. Science and Practice of Strength Training 2nd Edition. Human Kinetics (2006).

Physical Training
WHY DO YOUR GRANDPARENTS NEED TO START LIFTING WEIGHTS

 

If your grandfather is a normal person, it is very likely that he has been to the doctor many times, that he is on medication, that he does not hear very well and that he does not have the same locomotion capacity and reasoning that he had some years ago.

Doctors say this is “normal” and typical of the advancing age. They also prescribe drugs based on the belief that this will improve the quality of life of these people. I do not say that this is not necessary in some cases, but I do not believe that this is the best approach to increase health span. Although they “breathe” I think that they deserve better and more.

More than two years ago, a piece in a portuguese newspaper stated that the Portuguese lived longer and longer but less healthy. The piece also mentioned: “Portuguese women have one of the longest life expectancy in the world, but, paradoxically, enjoy far fewer healthy years than women from the best-ranked countries in Europe.”

When reading the piece, the first thing I thought was: we have to be really stupid, because even with the daily advances of medicine and scientific knowledge, we have not yet been able to understand what are the causes behind this SICK LONGEVITY. The problem is not the advancing years, the problem lies in nutrition and exercise related advice we hear every day (especially in hospitals), which is simply erroneous. If prevention campaigns and the information leaflets in hospitals were really supported by scientific evidence, one would not witness so many people suffering from chronic pain, diabetes, heart disease, osteoporosis, sarcopenia, autoimmune diseases and cancer.

Everyone recognizes that physical exercise is key to optimal body function (our brain and body did not develop while sitting on our asses), and that, unlike drugs, has a positive and self-regulating impact on the various systems of the human body.
Exercising is more effective on improving your health than any patented medicine.

“But I walk an hour every day”

Let me tell you one thing, walking is the least you can do to keep your body working. If you tell me that is either walking or lying back on the couch eating ice cream, then you better walk. But if you tell me that you want to live a healthy life until you die, maintain your autonomy, decrease the risk of falls, increase self-confidence, sleep better, recover faster from an injury and not be part of the statistics we saw above, then I recommend you start seriously thinking about lifting weights and engaging in strength training. Walking will not give you, even by shadows, the same benefits as strength training.

Another thing, if you are one of those people with cardiovascular disease, your doctor (or some Dr. from Google) has probably told you that walking is important to improve your cardiovascular health. The problem is that walking will not help you much. The lack of aerobic capacity is not a risk factor for heart disease, a sedentary lifestyle is! This means that you may have a huge aerobic capacity and a heart disease at the same time. In fact, according to this study published in the 2006 American Heart Association Journal (LINK), to this one published in 2008 in the European Heart Journal (LINK) and to this one published in the Mayo Clinic Proceedings (LINK) in 2012, marathoners are those who appear to be at increased risk of developing cardiovascular disease.

Furthermore, according to the cardiologist Henry A. Solomon in the book “The Exercise Myth”, cardiovascular health refers to the absence of heart and blood vessel disease, and not to an individual’s ability to do a certain amount of physical work. According to Dr. Solomon, your cardiac health is determined by the condition of various structures of the heart, including the heart muscle, the valves, the special cardiac tissues that carry electrical impulses and the coronary arteries. So, do not expect exercise to “clean” what you practice in your daily diet.

The cardio craze came about in the late 60’s / early 70’s through Dr. Kenneth Cooper, the person who designed the Cooper test for US military use. It was roughly from this moment on that VO2max (a measure of aerobic capacity) was “elected” the holy grail of physical fitness. Although relevant for performance and longevity, VO2max is not the only marker of physical fitness. Strength in its various forms has been more strongly correlated with increased longevity than VO2max. While strength training can increase both functional strength and aerobic capacity, the typical cardio training will not make you stronger and will only slightly “at best” increase your VO2max.

Why Strength Training?

Because you tend to lose strength and power as you age, and because several studies have shown that loss of strength and muscle mass are associated with increased mortality (LINK, LINK, LINK). Fortunately, lifting weights is the best stimulus to counteract this trend and to increase our functional capacity. Under normal conditions, strength peaks between the ages of 20 and 30, remaining relatively stable or decreasing slightly over the following 20 years. But this is dependent, of course, of what one does in training.

It is in the sixth decade of life that decreases in strength are quite pronounced. According to several longitudinal studies, declines in muscle strength are around 15% between 60-70 years of age and 30% after age 70. Most reasons relate to the loss of muscle mass, pronounced loss of fast-twitch muscle fibers, decreased endocrine function, loss of tissue mobility / elasticity and cell dehydration. All of these can be minimized by following a proper strength training program.

Yes, it is possible to start strength training at any age, I know people who started training at 50, 60 and over 80, it’s all a matter of mindset and willpower. Also, you need to train according to your needs as opposed to the convenience of most gyms (i.e. spending hours on the treadmill / elliptical / bike, going through all the machines and ignore training with free weights) where supervision, tutoring and skill learning are dismissed.

Does this mean that I should get my grandparents to lift Olympic bars and weights without any criteria? Of course not, that would not be very smart. To get the most benefit of lifting weights you have to walk a path and create a solid movement base. You have to be screened and assessed for movement quality and physical parameters. Preferably guided by a fitness professional or personal trainer knowledgeable in movement and strength training science.

Listen, your doctor’s opinion might be highly valuable, however remember the following: 1) your doctor is not a specialist in movement (which is ok, they can not be trained in everything); 2) your doctor has no experience training people (which is also ok, it’s not their job); 3) your doctor probably does not even know how to lift weights or to move well (this is obviously not ok!). In other words, just as you would not ask advice on surgery techniques from strength coaches, you should also not ask advice on training methodologies and forms of physical exercise from surgeons.

Oh, and before you tell me that I’m being fundamentalist and suggesting that you should not train other physical abilities (such as stability, mobility, endurance, speed, agility, motor coordination, power), allow me to conclude with the following observation: ideally, the training program of any human being on the planet should always be the one that induces the adaptations necessary to fulfill his /her personal goals.

The key word here is adaptation! The more adapted you are the better prepared you will be to face any situation. Adults are free to do whatever they want in life. Everyday we make decisions and choices and those decisions matter. My goal is to increase longevity and live until the last days of my life feeling great and strong.
What’s yours?

See you soon!

Pedro Correia

References

Möhlenkamp S, Lehmann N, Breuckmann F, Bröcker-Preuss M, Nassenstein K, Halle M, Budde T, Mann K, Barkhausen J, Heusch G, Jöckel KH, Erbel R; Marathon Study Investigators; Heinz Nixdorf Recall Study Investigators. Running: the risk of coronary events : Prevalence and prognostic relevance of coronary atherosclerosis in marathon runners. Eur Heart J. 2008 Aug;29(15):1903-10. doi: 10.1093/eurheartj/ehn163. Epub 2008 Apr 21.

Neilan TG1, Januzzi JL, Lee-Lewandrowski E, Ton-Nu TT, Yoerger DM, Jassal DS, Lewandrowski KB, Siegel AJ, Marshall JE, Douglas PS, Lawlor D, Picard MH, Wood MJ. Myocardial injury and ventricular dysfunction related to training levels among nonelite participants in the Boston marathon. Circulation. 2006 Nov 28;114(22): 2325-33. Epub 2006 Nov 13.

O’Keefe JH, Patil HR, Lavie CJ, Magalski A, Vogel RA, McCullough PA. Potential adverse cardiovascular effects from excessive endurance exercise. Mayo Clin Proc. 2012 Jun;87(6):587-95. doi: 10.1016/j.mayocp.2012.04.005.

Rantanen T, Harris T, Leveille SG, Visser M, Foley D, Masaki K, Guralnik JM. Muscle strength and body mass index as long-term predictors of mortality in initially healthy men. J Gerontol A Biol Sci Med Sci. 2000 Mar;55(3):M168-73.

Ruiz JR, Sui X, Lobelo F, Morrow JR Jr, Jackson AW, Sjöström M, Blair SN. Association between muscular strength and mortality in men: prospective cohort study. BMJ. 2008 Jul 1;337:a439. doi: 10.1136/bmj.a439.

Takata Y, Ansai T, Soh I, Akifusa S, Sonoki K, Fujisawa K, Awano S, Kagiyama S, Hamasaki T, Nakamichi I, Yoshida A, Takehara T. Association between body mass index and mortality in an 80-year-old population. J Am Geriatr Soc. 2007 Jun;55(6):913-7.

Zatsiorsky V., Kraemer, W. Science and Practice of Strength Training 2nd Edition.
Human Kinetics (2006).

Physical Training
STRENGTH TRAINING CAN REVERSE AGING

 

Several lines of evidence suggests that mitochondrial dysfunction is associated with sarcopenia (loss of strength and muscle mass in aging). In every cell of our body there are hundreds or thousands of mitochondria, they exist in greater quantity in the most active organs and tissues (muscles, heart and brain). The reason we age faster derives from the constant injuries and insults inflicted to the mitochondria. Chronic stress, lack of sleep, poor eating choices, lack of exercise (particularly strength training), alcohol, tobacco, and exposure to pollutants are just a few examples of how our lifestyle can influence the function of these small structures.

Mitochondria are the organelles responsible for energy production in our body. If you feel always tired, if you experience memory loss, if you have frequent muscle pain and if you are one of those people taking medications for cholesterol, hypertension, diabetes and other chronic diseases, it is very likely that your mitochondria are not in “great shape”. But let’s look at some evidence.

This study may be considered revolutionary because of its highly relevant findings regarding the benefits of strength training in older people. This study was published in 2007 and was the first study human study to demonstrate that strength training can reverse the aging process at molecular level. If it was a drug or a food supplement demonstrating these effects, I think everyone already knew.

Sample

The researchers recruited 25 healthy elderly people (mean age 68 years), who already did some type of physical exercise (walking, gardening, tennis, golf, cycling) three to four times a week, and 26 young adults (mean age 24 years) relatively inactive, some of them participating in recreational activities.

The authors selected relatively active older adults and sedentary young adults in order to study the aging process on healthy elderly and not just the putative aging effect of physical inactivity. All older subjects underwent a thorough screening process before being admitted to the study to ensure that other factors (e.g. metabolic diseases) would alter mitochondrial function.

All subjects completed a medical evaluation before participating in the study. Exclusion criteria were: evidence of heart disease (by history and sub-maximal graded exercise test); hypertension; chronic obstructive pulmonary disease; diabetes mellitus; renal insufficiency; orthopedic injury and smoking. None of the subjects had previously participated in a structured resistance training program.

Training Program

Subjects performed resistance exercises with supervision on two nonconsecutive days of the week (monday/thursday or tuesday/friday) for 26 weeks (six months). The subjects performed twelve different exercises including chest press, leg press, leg extension, leg flexion, shoulder press, lat pull-down, seated row, calf raises, crunches, back extensions, bicep curl and triceps extension.

Subjects initially started with a set of 50% of 1 maximal repetition (1RM), and gradually increased to three sets at 80% of their 1RM during the intervention period. Subjects tested their 1RM for every exercise every two weeks, and training loads were adjusted to maintain 80% of their 1RM.

Muscular Biopsy

All younger subjects (N = 26) underwent a muscle biopsy (incision and extraction of a small part of muscle) from the vastus lateralis (thigh muscle) before and after the 26-week study. The elderly subjects (= 25) did their biopsies before the study and after (N = 14) of the study. Muscle RNA (ribonucleic acid) was analyzed to determine age-related gene expression variation.

Results

The authors identified 596 genes that were differentially expressed between the two age groups. Of the 596 genes, the researchers identified 179 associated with age and exercise that showed a remarkable reversal in their expression profile after six months of resistance training. This literally means that resistance training not only can slow down but also reverse the aging process at the genetic level. The genetic expression of the elderly individuals became similar to those of the younger group. The researchers also noted that mitochondrial dysfunction (closely related to physical inactivity) began to reverse after six months of training.

As for muscular strength, results were as expected, that is, the ones who strength trained got stronger. The initial gap of 59% in maximal isometric strength in older people vs. young adults was reduced to 38% after six months of resistance training.

Conclusions

Nowadays, it is widely accepted that physical exercise is associated with a decrease in morbidity and mortality in humans. This is not a belief. What people probably do not know is that there are forms of physical exercise that are more effective in increasing strength and longevity. This study demonstrated for the first time that resistance training can reverse age-related aspects at the gene level. Yes, you are reading well, resistance training can reverse aging at the molecular level!

The fact that older people got stronger was no surprise to me and certainly not for fitness professionals. It is not uncommon for older people to begin their training with minimum weights and, in a short time, evolve to loads equal to or greater than those in their twenties. It’s all about dedication, consistency and method.

Over the years, personal trainers and fitness professionals have been preaching their clients / athletes about the importance of physical exercise in improving health. This message, in my opinion, has not been well perceived by most people. Understanding the notion that movement and physical exercise is as important as the food they eat every day is, unfortunately, still lacking.

In short, this fascinating study is basically telling us that it is within our power to increase health and longevity. In this case, the “fountain of youth” is something we know and something that is relatively accessible to everyone – Strength Training.

However, for these benefits to occur, people have to be willing to work hard and with consistent effort, something rare in our “all in moderation” oriented society. Most people are in search of a miraculous pill and rather rely on faith than doing something for themselves. Therefore, I believe that only focused individuals and those who follow these principles in training (and in life) will end up having the most benefits. Things will not happen by chance, certainly.

See you soon!

Pedro Correia

References

Melov S, Tarnopolsky MA, Beckman K, Felkey K, Hubbard A (2007) Resistance Exercise Reverses Aging in Human Skeletal Muscle. PLoSONE 2(5): e465. doi:10.1371/ journal.pone.0000465