Resistance Training: What’s That? The Battle Against Sarcopenia

December 01, 2007

Resistance Training:  What’s That? The Battle Against Sarcopenia 

 Competency # 4 Activity                                Reference: (Circulation. 2007;116:572-584.) 

Resistance Exercise in Individuals With and Without Cardiovascular Disease: 2007 Update

 I can’t learn to exercise if I don’t know the facts.  How long you live can be predicted, in part, by how well you squeeze a standard hand grip.  That’s muscle strength. Different than “aerobic capacity”, it’s muscle mass and strength.  And we use it or lose it.  Resistance training is the state of the art tool in the battle of aging decline.  In addition to walking 30 minutes every day, we need to keep our muscles.   At least preserve them.  RT is it. 

 Resistance Training.  And the American Heart Association just released its new recommendations.  Here’s why… Did you know that for every two days of bed rest, the heart rate increases one beat?  Were you aware that your rate of bone loss increases 50 times with bed rest, and returns 4 times slower than the rate at which you lost it?  And did you know that for every week of complete bed rest, your muscle strength drops by 10-15%?  Within 8 hours of immobilization of a muscle in a cast or a splint, muscle fibers begin to shorten, limiting full range of motion? (Same effect as after sitting in a movie theatre for just two hours – only worse and measurable).  

As we are aging and living into our 80s and 90s, we need to learn the strategies with which we can do it successfully.  Unfortunately, it doesn’t come free.  (But you can do this watching Mystery on PBS!)   Sarcopenia.  That’s the dread term for muscle loss with age.  Muscles burn calories, even when they are not being used.  As we get older, we lose a pound of muscle a year, and thereby lose our internal furnace.  “I feel like I’m slowing down”.   “No matter what I eat, the calories just stay.”   Those are all secret terms for sarcopenia.  So, we move less, lose muscle and the vicious cycle gets worse and worse. 

Here’s the Journal Circulation’s Table of Recommendations on how to do it… 

1.   Resistance training should be performed In a rhythmical manner at a moderate to slow controlled speed 

2.   Through a full range of motion, avoiding breath-holding and straining (Valsalva maneuver) by exhaling during the contraction or exertion phase of the lift and inhaling during the relaxation phase 

3.   Alternating between upper- and lower-body work to allow for adequate rest between exercises.  

4.   The initial resistance or weight load should allow for and be limited to 8–12 repetitions per set for healthy sedentary adults or 10–15 repetitions at a low level of resistance, for example, <40% of 1-RM, for older (>50–60 y of age), more frail persons, or cardiac patients 5.  Be limited to a single set performed 2 d/wk Involve the major muscle groups of the upper and lower extremities, eg, chest press, shoulder press, triceps extension, biceps curl, pull-down (upper back), lower-back extension, abdominal crunch/curl-up, quadriceps extension or leg press, leg curls (hamstrings), and calf raise 

WWW:  What Will Work for Me?  Well.  As you know.  I’m in Planning Mode still.  That’s stage 3 on the change journey.  And I just found out about this RT stuff.  So, I can hold off and deny it a bit longer.  (Denial is Stage 1 and gives you lots of time to dodge and parry)  I have walked every day this week.  That’s a tentative start on Stage 4, Action.  Let’s see if I can keep it up.  The Harvard Men’s Health study would be proud.  Walking 30 minutes a day is one of the 5 strategies they found correlated with an 87% reduction in heart disease risk.  I don’t want to just avoid a heart attack.  I want to live to be a healthy 85-year-old.  And I want you there for my 85th birthday.  So, I’ll get some weights?  Someday.  Meanwhile, the table above and the table below. Stages of Change:  This applies to all change processes.  Weight loss, smoking cessation, exercise… (Prochaska and Norcross) 1.  Stage One:  Denial   (Pretend you never heard of it) 2.  Stage Two:  Think about it.  Grudgingly admit it may be true. 3.  Stage Three:  Plan to change.  Get some enthusiasm.  At least your attitude changes and you think it might just be a good idea. 4.  Stage Four:  ACTION.  Give it a try.  Determined. 5.  Stage Five:  FAILURE.  I think the most important stage of all.  This defines how hard it is, and your determination to learn from your lapses.  The most human stage. 6.  Stage Six:  Done.  Finished.  Move on.  It’s a new habit, a new culture.  When you see me in Spandex:  I’ll be there.

The column written by Dr. John E. Whitcomb, MD, Brookfield Longevity, Brookfield, WI (262-784-5300)