Strength Training: What are the health benefits?

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Physical inactivity is labelled as a major health problem worldwide. Available data suggests that a lack of physical activity is not only a major risk factor for mortality but has economic consequences (1). Even though these findings are well documented, only ~24.4% of U.S. adults aged 18 and over meet the Physical Activity Guidelines for both strength training and aerobic training (2).

Key points:  

  1. Strength training is inversely associated with the risk from cardiovascular disease, cancer, diabetes, and all-cause mortality 
  2. Adults in the U.S. should perform resistance training of moderate or greater intensity involving all major muscle groups on 2 or more days per week  
  3. Available evidence suggests that a combination of strength training and cardiovascular training confers greater health benefits than either modality alone.  

Muscular strength is defined as the production of force measured in a specific context and can be displayed in a variety of ways. From a general standpoint, strength training improves body composition, cardiovascular risk profile, and psychosocial health (3, 5, 6, 8).  We’ve also seen a reduced risk of cancer specific mortality (7). Furthermore, strength training provides specific benefits, which include increases in strength, power, muscle mass, bone mineral density, and anaerobic capacity (4-6).

There are even medical conditions that can be improved with strength training, including but not limited to:  

  • Endocrine-metabolic: diabetes, metabolic syndrome, and excess adiposity (14-16) 
  • Cardiovascular: hypertension, heart failure, coronary artery disease, and peripheral vascular disease (3,11-13) 
  • Musculoskeletal: sarcopenia (progressive loss of muscle mass in aging adults), osteoarthritis, osteopenia, and osteoporosis (5, 20-23) 
  • Gastrointestinal: cirrhosis and nonalcoholic fatty liver disease (9,10) 
  • Neurological: stroke and Parkinson disease (18,19) 
  • Psychological: anxiety and depression (8)  
  • Immunology: immune competency (17) and certain autoimmune diseases  

Additionally, a recent systematic review and meta-analysis suggested that strength training was inversely associated with the risk for cardiovascular disease, cancer, diabetes, and all-cause mortality independent of aerobic exercise activities (24). 

To summarize, strength training provides a wide range of benefits and has the potential to improve a variety of disease processes.  This, however, does not negate the fact that a combination of strength training and cardiovascular training confers greater health benefits than either modality alone.  Therefore, it is recommended that most adults should be working towards the physical activity guidelines for both strength training and aerobic activities, which are stated as: 

  • 150 to 300 minutes per week of moderate-intensity aerobic physical activity, OR;
  • 75 to 150 minutes per week of vigorous-intensity aerobic physical activity, AND;
  • Resistance training of moderate or greater intensity involving all major muscle groups on 2 or more days per week.

 

References:

  1. Ding, D., Lawson, K. D., Kolbe-Alexander, T. L., Finkelstein, E. A., Katzmarzyk, P. T., van Mechelen, W., Pratt, M., & Lancet Physical Activity Series 2 Executive Committee (2016). The economic burden of physical inactivity: a global analysis of major non-communicable diseases. Lancet (London, England), 388(10051), 1311–1324. https://doi.org/10.1016/S0140-6736(16)30383-X
  2. Elgaddal, N., Kramarow, E. A., & Reuben, C. (2022). Physical Activity Among Adults Aged 18 and Over: United States, 2020. NCHS data brief, (443), 1–8.  
  3. Naci, H., Salcher-Konrad, M., Dias, S., Blum, M. R., Sahoo, S. A., Nunan, D., & Ioannidis, J. P. A. (2019). How does exercise treatment compare with antihypertensive medications? A network meta-analysis of 391 randomised controlled trials assessing exercise and medication effects on systolic blood pressure. British journal of sports medicine, 53(14), 859–869. https://doi.org/10.1136/bjsports-2018-099921 
  4. Ozcivici, E., Luu, Y. K., Adler, B., Qin, Y. X., Rubin, J., Judex, S., & Rubin, C. T. (2010). Mechanical signals as anabolic agents in bone. Nature reviews. Rheumatology, 6(1), 50–59. https://doi.org/10.1038/nrrheum.2009.239
  5. Schoenfeld, B. J., Grgic, J., Ogborn, D., & Krieger, J. W. (2017). Strength and Hypertrophy Adaptations Between Low- vs. High-Load Resistance Training: A Systematic Review and Meta-analysis. Journal of strength and conditioning research, 31(12), 3508–3523. https://doi.org/10.1519/JSC.0000000000002200
  6. Schoenfeld, B. J., Ogborn, D., & Krieger, J. W. (2017). Dose-response relationship between weekly resistance training volume and increases in muscle mass: A systematic review and meta-analysis. Journal of sports sciences, 35(11), 1073–1082. https://doi.org/10.1080/02640414.2016.1210197
  7. Shailendra, P., Baldock, K. L., Li, L. S. K., Bennie, J. A., & Boyle, T. (2022). Resistance Training and Mortality Risk: A Systematic Review and Meta-Analysis. American journal of preventive medicine, 63(2), 277–285. https://doi.org/10.1016/j.amepre.2022.03.020
  8. Singh, N. A., Stavrinos, T. M., Scarbek, Y., Galambos, G., Liber, C., & Fiatarone Singh, M. A. (2005). A randomized controlled trial of high versus low intensity weight training versus general practitioner care for clinical depression in older adults. The journals of gerontology. Series A, Biological sciences and medical sciences, 60(6), 768–776. https://doi.org/10.1093/gerona/60.6.768
  9. Tandon, P., Ismond, K. P., Riess, K., Duarte-Rojo, A., Al-Judaibi, B., Dunn, M. A., Holman, J., Howes, N., Haykowsky, M. J. F., Josbeno, D. A., & McNeely, M. (2018). Exercise in cirrhosis: Translating evidence and experience to practice. Journal of hepatology, 69(5), 1164–1177. https://doi.org/10.1016/j.jhep.2018.06.017
  10. Zelber-Sagi, S., Buch, A., Yeshua, H., Vaisman, N., Webb, M., Harari, G., Kis, O., Fliss-Isakov, N., Izkhakov, E., Halpern, Z., Santo, E., Oren, R., & Shibolet, O. (2014). Effect of resistance training on non-alcoholic fatty-liver disease a randomized-clinical trial. World journal of gastroenterology, 20(15), 4382–4392. https://doi.org/10.3748/wjg.v20.i15.438
  11. Marzolini, S., Oh, P. I., & Brooks, D. (2012). Effect of combined aerobic and resistance training versus aerobic training alone in individuals with coronary artery disease: a meta-analysis. European journal of preventive cardiology, 19(1), 81–94.https://doi.org/10.1177/1741826710393197
  12. Giuliano, C., Karahalios, A., Neil, C., Allen, J., & Levinger, I. (2017). The effects of resistance training on muscle strength, quality of life and aerobic capacity in patients with chronic heart failure – A meta-analysis. International journal of cardiology, 227, 413–423. https://doi.org/10.1016/j.ijcard.2016.11.023
  13. de Sousa, E. C., Abrahin, O., Ferreira, A. L. L., Rodrigues, R. P., Alves, E. A. C., & Vieira, R. P. (2017). Resistance training alone reduces systolic and diastolic blood pressure in prehypertensive and hypertensive individuals: meta-analysis. Hypertension research : official journal of the Japanese Society of Hypertension, 40(11), 927–931. https://doi.org/10.1038/hr.2017.69
  14. Ishiguro, H., Kodama, S., Horikawa, C., Fujihara, K., Hirose, A. S., Hirasawa, R., Yachi, Y., Ohara, N., Shimano, H., Hanyu, O., & Sone, H. (2016). In Search of the Ideal Resistance Training Program to Improve Glycemic Control and its Indication for Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. Sports medicine (Auckland, N.Z.), 46(1), 67–77.https://doi.org/10.1007/s40279-015-0379-7
  15. Khalafi, M., Malandish, A., Rosenkranz, S. K., & Ravasi, A. A. (2021). Effect of resistance training with and without caloric restriction on visceral fat: A systemic review and meta-analysis. Obesity reviews : an official journal of the International Association for the Study of Obesity, 22(9), e13275. https://doi.org/10.1111/obr.13275
  16. Strasser, B., Siebert, U., & Schobersberger, W. (2010). Resistance training in the treatment of the metabolic syndrome: a systematic review and meta-analysis of the effect of resistance training on metabolic clustering in patients with abnormal glucose metabolism. Sports medicine (Auckland, N.Z.), 40(5), 397–415. https://doi.org/10.2165/11531380-000000000-00000
  17. Campbell, J. P., & Turner, J. E. (2018). Debunking the Myth of Exercise-Induced Immune Suppression: Redefining the Impact of Exercise on Immunological Health Across the Lifespan. Frontiers in immunology, 9, 648. https://doi.org/10.3389/fimmu.2018.00648
  18. Morris, S. L., Dodd, K. J., & Morris, M. E. (2004). Outcomes of progressive resistance strength training following stroke: a systematic review. Clinical rehabilitation, 18(1), 27–39. https://doi.org/10.1191/0269215504cr699oa
  19. Corcos, D. M., Robichaud, J. A., David, F. J., Leurgans, S. E., Vaillancourt, D. E., Poon, C., Rafferty, M. R., Kohrt, W. M., & Comella, C. L. (2013). A two-year randomized controlled trial of progressive resistance exercise for Parkinson’s disease. Movement disorders : official journal of the Movement Disorder Society, 28(9), 1230–1240. https://doi.org/10.1002/mds.25380
  20. Maestroni, L., Read, P., Bishop, C., Papadopoulos, K., Suchomel, T. J., Comfort, P., & Turner, A. (2020). The Benefits of Strength Training on Musculoskeletal System Health: Practical Applications for Interdisciplinary Care. Sports medicine (Auckland, N.Z.), 50(8), 1431–1450. https://doi.org/10.1007/s40279-020-01309-5
  21. Kristensen, J., & Franklyn-Miller, A. (2012). Resistance training in musculoskeletal rehabilitation: a systematic review. British journal of sports medicine, 46(10), 719–726. https://doi.org/10.1136/bjsm.2010.079376
  22. Tanaka, R., Ozawa, J., Kito, N., & Moriyama, H. (2013). Efficacy of strengthening or aerobic exercise on pain relief in people with knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Clinical rehabilitation, 27(12), 1059–1071. https://doi.org/10.1177/0269215513488898
  23. Watson, S. L., Weeks, B. K., Weis, L. J., Harding, A. T., Horan, S. A., & Beck, B. R. (2018). High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 33(2), 211–220. https://doi.org/10.1002/jbmr.3284
  24. Momma, H., Kawakami, R., Honda, T., & Sawada, S. S. (2022). Muscle-strengthening activities are associated with lower risk and mortality in major non-communicable diseases: a systematic review and meta-analysis of cohort studies. British journal of sports medicine, 56(13), 755–763. https://doi.org/10.1136/bjsports-2021-105061