In my last post I broke down what the Sick Aging Phenotype is and how exercise is a significant component in combating the slow train wreck that is the aging process. Even without having read it (which I know most of you didn’t) you already knew exercise was good for you. Your doctors, family, and media have been telling you that for years! You know your body is made to move and not sit on your butt 10 of the 18 hours you’re awake – yet here you are. But what constitutes exercise? As much as I say otherwise… but… Walking. Yoga. Cleaning your house. Running. Hiking. Swimming. Lifting weights. Pilates. ALL OF IT IS BETTER THAN SITTING ON YOU’RE A$$. Obviously, some of these forms of exercise are far better than others. If we consider our last post’s conclusion that exercise is indeed medicine, then we can think of exercise coming in different formulations, dosing strengths, routes of administration and side effects – just as medications do. Some medicine is powerful like the strongest chemo drugs you can get; others are like 2 Advil you pop for your crappy knee, somewhat soothing but generally ineffective. Exercise, just like medications, can be overprescribed and used in excess.
So, what is the best type and dose of exercise to combat the aging process we are all inevitably fighting against? The programming you find at PLF.
How do we ensure compliance with the medication regime? The community at PLF.
Type of Exercise & The Sick Aging Phenotype
We all know not all forms of exercise are created equal but evaluating that in scientific studies is hard. Without going into the details, designing a randomized, controlled study and comparing them to others is hard because it depends on the metrics used to evaluate the outcome. There is a ton of data out there but sorting through it and coming away with a definitive conclusion can’t be done. For every five articles you find supporting strength training, you’ll find a few that disagree. I’m going to briefly summarize the overwhelming preponderance of data that shows strength training is the superior form of exercise for combating our mortal enemy – aging. Of course, I am biased, so I implore you to do some research on your own.
Any form of exercise in conjunction with less crap food will have a positive impact on the Sick Aging Phenotype. Traditional thinking was that aerobic exercise was your ticket to a smaller waist. However the current data is showing that strength training is not only more effective than aerobic exercise, but that building muscle contributes to the loss of visceral fat (i.e., your spare tire), which is closely more associated with development of metabolic syndrome, than total bodyfat. Visceral fat is actively involved in the inflammation process, which promotes degenerative changes in blood vessels and other tissues that drive the development of the Sick Aging Phenotype. Resistance training not only increases the activity of the muscle but also the mass of the muscle, which has a multiplier effect on the impact of exercise on the metabolism, so you’re expending energy even at rest. In short, strength training has the power to fight visceral fat accumulation, a major player in development of disease.
Strength training is also closely associated with Type 2 diabetes. Vigorous exercise creates a demand for energy (in scientific terms, ATP) and it’s usually through the action of insulin that cells will suck calories out of the bloodstream for work. In Type 2 diabetes this process is disrupted. Study after study has shown that strength training increases skeletal muscle insulin sensitivity, increase muscle glucose uptake, promotes glucose tolerance, and decreases the high serum insulin levels seen in patients with Type 2 diabetes. Furthermore, an important systematic review of the literature done by Irvine and Taylor that included 9 randomized controlled trials totaling 372 people found that progressive resistance training (i.e. actual training – increasing weight lifted at regular intervals), reduced HbAc1 in patients with Type 2 diabetes. HbAc1 is an important biomedical marker for Type 2 diabetes, cardiovascular disease and metabolic syndrome.
Multiple studies have shown that muscular strength is inversely related to the presence of metabolic syndrome. The stronger you are, the less likely you will develop the characteristics of the Sick Aging Phenotype and ending up a demented meat-pretzel in a nursing home waiting for the next bout of sepsis to finally put you out of your misery. A very detailed retrospective analysis of 13 randomized controlled studies found, when pooled and analyzed, strength training had a positive effect on obesity, reduced levels of HbAc1, and blood pressure. The authors concluded with a recommendation that strength training be incorporated into any treatment plan for patients with metabolic syndrome. And yet ANOTHER study in 2012 found that when conditioning is added to the strength training program, the effect on insulin is even more dramatic. This all points to one conclusion: people who remain active, stay strong, and eat wisely do not develop diabetes.
In terms of cardiovascular health, the data is mixed. Cardiovascular disease encompasses a huge range of disease states: hypertension, dyslipidemia (messed up serum lipid profiles), heart failure, and coronary artery disease. The evidence to date supports the idea that endurance training is marginally superior to weight training with respect to cardiovascular health. However, as previously pointed out, adding a conditioning program to any strength training program not only further reduces the risk of developing diabetes but it also adds the cardiovascular component to your fitness. Therefore, we do burpees, kettle bell swings, and some RUNNNNIN’ every now and then.
Other aspects of the Sick Aging Phenotype are sarcopenia (loss of muscle cells), muscular atrophy (loss of muscle mass) and osteopenia (loss of bone density). Muscle loss is an endemic in older populations, and it predicts frailty and loss of independence. This makes sense because muscles allow us to move around and when those muscles have atrophied, you become weak and unable to complete physical tasks needed for independence. Limited studies have found biomarkers in older adults that indicate higher levels of proteins that are known to have a negative impact on muscle mass. Adults who do not engage in regular strength training lose up to 1 pound of muscle per year. READ THAT AGAIN. The dominant factor in this process is the loss of Type II muscle fibers, the largest most power muscle fibers. By age 80, untrained individuals have lost up to 50% of these muscle fibers. Loss of muscle prevents us from being able to move our bodies in any meaningful way. When we strength train and eat well we are promoting growth factors and thus signaling to our bodies that we are in a physiological environment for favoring growth, repair, and survival.
Mark Rippetoe, the guy who started Starting Strength, has a favorite phrase: “strong people are harder to kill”. And it’s true. Muscles and ligaments made strong by strength training are less likely to become brittle and snap. Bones made hard and dense by programmed, progressive training are resistant to fracture. Minds made tough by struggling under the bar or with that heavy kettle bell awake the possibilities of ongoing physical accomplishments achieved by training, are less likely to succumb to depression. The loss of strength, flexibility and adaptive physiologic reserves is typically accompanied by an equally deadly decline in mental health. Aging adults see their situation as hopeless and subsequently lowers their expectations and efforts, thereby growing even weaker. The internal cues, “I’m fat. I’m weak. I’m worthless. My joint ache. Where are the Oreos?” The Sick Aging Phenotype is a living hell of progressive weakness, obesity, inactivity, lower expectations, sexual impotence, mounting despair, a growing list of medications, learned helplessness, sickness and pain. Its waiting to die from a minor skin infection or broken hip or blood clot or needing a stupid go cart to get around the store, of not being able to wipe your own butt, of numbing yourself with cigarettes, alcohol, Netflix and junk food so you don’t have to face your own sad existence.
The conclusion from all the studies I read, combined with my own personal experience as a human and expert trainer, was that strength training, in conjunction with conditioning (such as high intensity interval training/HIIT) is your weapon against helpless, pathetic aging. When you think of aging, you cannot just consider money. You MUST consider your health – your bones, tendons, muscles, strength, mobility and function – otherwise you’ll retire an affluent meat pretzel unable to do anything never mind make your golden years enjoyable. Your physical health is as important as the amount in your 401k. If you are serious about living your life in the most robust way possible, the programming at PLF is your answer.
The Answer: Community Support
Now that we’ve analyzed the data and concluded that the strength training + conditioning found at PLF equals power and mobility – keys to keeping an edge on the aging process – let’s look at how to incorporate it into our daily lives.
The literature on this subject indicates 30 minutes per day of moderate exercise is enough to get some physiological benefit and we’ve shown that, depending on the exercises performed in those 30 minutes, it can make a big impact on the Sick Aging Phenotype. However, setting aside time to exercise is HARD; getting to the gym is HARD; motivating YOURSELF to DO THE EXTRA rep, ADD more weight, GO DEEPER in your squat, or GO FASTER is only possible for the most driven of athletes.
Sure, you might begrudgingly show up at the gym, stand around and look cute in your workout clothes, maybe sit on a weight machine, and bust out some bicep curls (more on the horrors of machines later…), or walk on a treadmill (that’s actually plugged in… gasp!). But none of that is making you stronger or healthier. You walk out of that big box gym, having not even broken a sweat, being sure to grab a slice of pizza on your way out, no better off than you were when you went in. You know this isn’t working. You know you’re just wasting your money. You dread the gym and aren’t making any progress. So, you hire a personal trainer, who follows you around with her little clipboard, whose credentials consist of a weekend seminar put on by some guy who has no business training anyone, showing you all of the MACHINES you’ll SIT on to get you “strong”. After adding this cost to your membership fee, you’re up over $150 for a gym that isn’t doing crap for you and your health. These gyms don’t care whether you get strong or shrivel up and die.
At PLF we believe exercise is medicine and the best exercise is strength training. You made it; you lift it – and not by sitting on machines, but by moving your body and by getting stronger in basic movements required to sustain independence and quality of life. The exercise needed to combat the aging process is intense, as it should be – you’re fighting for your life and independence. Engaging in that level of fitness is hard and the only way to achieve it and see significant results is by utilizing a support system.
We aren’t like the big box gyms or the specialty boutique style gyms you see popping up that charge astronomical rates guaranteeing you’ll get “a dancer’s body” using 2 pound weights, be “boxing ring ready” without having to do any significant weight training and conditioning or “be in the zone” by wearing a silly device that doesn’t measure anything meaningful for most of the population. We aren’t like the fancy gadgets you can buy to outfit a gym in your house, nor will you find them at our facility; we are a no-frills, real support system, inside the gym and out. We will push you to be and do your best in real like. There’s no gadget that can replace yours truly.
So while our programming is top notch and unmatched by any other fitness facility in NH, it is our members, the PLF community, and the comradery that make my clients succeed. When you’re struggle to get to the gym, we will harass you to show up. When you’re to tired to do another rep, we’ll push you to do 2 instead. When you think, “there’s no way I can lift that”, you will, your confidence will grow and next week you’ll add 10 pounds to the bar. You will be amazed at what your body is capable of. We are here to support you in your wellness journey, whether you’re just starting out or have been a gym buff for years. We want to see you get stronger and healthier. If you are serious about getting strong and healthy, about becoming harder to kill, then come check us out.
References and Further Reading
Sullivan, J. (2016). Barbell prescription: Strength Training for Life After forty. Aasgaard Company, The.
Fulginiti, “The Millennium in Infectious Diseases”
National Vital Statistics Report 2002
Ogden et al., “Prevalence of Obesity”
Park et al., “The Metabolic Syndrome,” 427-436.
Johnson and Sundquist, “Change in Lifestyle Factors,” 1073-1080
van Dam et al., “Combined Impact of Lifestyle Factors”
Gary Taubes, Good Calories, Bad Calories
Batsis et al., “Normal Weight Obesity and Mortality” 1592-1598.
Williams et al., “Resistance Exercise in Individuals” 572-584
Schaffler et al., “Adipose Tissue as an Inflammatory Organ” 449-467
Berg and Scherer, “Adipose Tissue, Inflammation and Cardiovascular health” 939-949
Fontanna et al., “Visceral Fat Adipokine Secretion,” 1010-1013
Schmitz et al., “Strength training for Obesity Prevention” 326-333
Ross et al., “Influence of Diet and Exercise” 2445-55
Bruunsgaard et al., “Muscle Strength After Resistance Training” 237-241
Campbell et al., “Increased Energy Requirements” 167-175
Strasser et al., “Resistance training, visceral obesity” 578-591
Hurley and Roth, “Strength Training in the Elderly” 249-268
Stensvold et al., “Strength training vs Aerobic Interval Training” 804-810
Perseghin et al., “Increased Glucose Transport-phosphorylation” 1357-1362
Erikkson et al., “Exercise and the Metabolic Syndrome” 125-135
Reed et al., “Effects of High and Low Volume Resistance Exercise” 251-260
Croymans et al., “Resistance Training Improves Indices” 1245-1253
Durak et al., “Randomized Crossover Study of Resistance Training” 327-334
Conceicao et al., “Sixteen weeks of Resistance Training” 1221-1228
Castaneda et al., “Randomized Controlled Trial of Resistance Exercise” 2335-41
Irvine and Taylor, “Progressive Resistance Exercise Improves” 1345-54
Jurca et al., “Association of Muscular Strength with Metabloic Syndrome” 1849-1855
Wijndaele et al., “Muscular Strength, Aerobic Fitness” 233-240
Strasser et al., “Resistance Training in the Treatment of Metabolic Syndrome” 397-341
Grontved et al., “Prospective Study of Weight Training” 1306-1312
Whitman et al., “Contributions of the Ubiquitin-proteasome Pathway” 437-46
Nelson et al., “High intensity strength training” 1909-1914
Larsson, “Histochemical Characteristics of Human Skeletal Muscle” 469-471
Nilwik et al., “Decline in Skeletal Muscle Mass” 492-8
