For a long time, strength training was the overlooked little brother of aerobic exercise. Exercise recommendations focused on improving aerobic fitness as the key to good health.
But research has finally shown that resistance exercises (weight lifting and other strength training methods) also have good effects on health and quality of life. Strength training builds bone, improves balance, improves flexibility, provides energy, and helps with weight control. It's now clear that people need both aerobic and strengthening exercise.
Who Needs Strength Training?
Oddly enough, the people most in need of strength training are the ones least likely to pursue it.
Of course, strength training is useful for everyone. It makes all sorts of everyday activities--carrying books or groceries, shoveling snow, raking leaves, opening heavy doors, hanging storm windows, carrying suitcases--easier. But some groups are particularly in need of strength training.
The elderly are one such group. People often become less active as they get older. Only 30 percent of people over the age of 65 say that they exercise regularly. Without exercise, people lose their strength, and everyday life becomes harder.
Exercise can reverse this deterioration and improve quality of life. For example, inactive people tend to become unable to care for themselves between ages 80 and 85. People who exercise regularly preserve strength and healthy oxygen levels in the blood longer--10 to 20 years longer, in fact. As a result, they are likely to be at least 90 to 100 years old before they lose their independence.
In studies with frail or very elderly people, strengthening exercises have had big benefits. Such people increase their strength greatly. As a result, they can walk and climb stairs faster. Some throw their canes away. Better balance results in fewer falls and thus fewer injuries from falls.
Women past menopause are another group that particularly needs strength training. Bone and muscle start to decrease in women at about age 40. Bone loss speeds up after menopause. According to the National Osteoporosis Foundation, half of women over age 50 can expect to break a bone because of osteoporosis sometime during their lifetime.
Strength-building exercise not only stops the loss of bone density, it actually reverses it. Postmenopausal women who do strengthening exercises build new bone and acquire better balance. They then fall less often and are less likely to be injured if they do fall.
Starting A Strength-Building Plan
As with any exercise program, it's vital to start by visiting your doctor and discussing your intentions. Follow safe exercise guidelines. (See "Adapting Exercise To Your Health" page 77.)
Strength versus endurance. The basic principle of building strength is that muscles become stronger when forced to work near their maximum ability. Lifting soup cans won't do anything for you (unless you are extremely out of shape). You need to use a weight that takes some effort to move.
How much effort? That depends on whether you wish to build strength, endurance, or both.
For building strength, choose a weight you can lift only two to six times. You should rest between sets (batches of lifts) for a few minutes.
For building endurance, choose a weight you can lift only 15 to 20 times. You should rest no more than a minute between sets.
For building both strength and endurance, choose a weight you can lift only eight to 12 times. Rests between sets should be 1 to 2 minutes. A combination approach is the best for most people, and this article will assume you are following a combination method.
You can take the old-fashioned approach and use barbells, dumbbells, and leg weights. Or you can go the modern route and use weight machines at a gym. Both probably work equally well.
Sit-ups, pull-ups, and push-ups also are strength-building exercises. In these, your own body acts as the weight that you lift.
For best results, do exercises that involve all the important muscle groups. These include the hips and legs, the shoulders, the abdomen, the chest, the back, and the arms. If you go to the gym, someone can help you choose good exercises for each area. If you plan to work out at home, it's a good idea to start by working with an exercise physiologist or personal trainer to learn how to use your equipment and how to do the exercises correctly. Ask your health care provider or diabetes educator for a recommendation or find one at the National Strength and Conditioning Association's Web site at www.nsca-lift.org/CPTReferrals/ searchCPT.asp.
Your exercise session. Start each weight-lifting session by warming up. Good warm-ups for weight lifting include slowly going through your routine without weights, standing up and sitting down in your chair 10 times, walking up and down a flight of steps, or doing 5 to 10 minutes of walking, bicycle riding, or marching in place, followed by some stretching. The older you are or the more extreme the weather (hot or cold), the longer your warm-up (and cool down) should be.
Next, lift the weight eight times (this is called one set). Form is important, both for good results and for safety. To achieve good form:
* Lift slowly and smoothly; don't heave. Lower slowly as well; don't drop the weights. "Slowly" means lifting to a count of four seconds and lowering to a count of four.
* Breathe out when you lift weights and in when you lower weights. Be very sure not to hold your breath, which can be dangerous, especially for people with diabetes, glaucoma, or heart disease. Counting your seconds out loud ensures that you are not holding your breath.
* Maintain good posture, relaxed but standing straight.
* Relax all your muscles except the one being exercised.
* Exercise in front of a mirror so you can monitor how you are doing the exercises.
Whether you should repeat the set, and if so, how many times, is controversial. Some experts say one set of each exercise for each body part is enough. Other experts recommend doing two or three sets of each. Muscles grow almost as fast with one set as with three; however, three sets burn more calories.
Finally, cool down. Stretching or walking for 5 to 10 minutes is a good cool down.
Your exercise plan. There's no need to lift weights every day. In fact, it's better not to. For muscles to become stronger, they need to exert themselves and then they need to rest and heal. So two or three weight-lifting sessions a week, separated by at least one day, are plenty.
As time goes by, it will get easier and easier to lift a specific weight. You'll be able to lift it nine times, then 10, then 11, then 12. Once you get to that point, it's time to increase the weight for that exercise so that you can lift it only eight times. Don't increase all the weights for all your exercises just because you are ready to increase one weight. Let each body part grow in strength at its own rate.
There will come a time when you've achieved your goals. At that point, you may want to switch from working to become stronger to working to maintain the strength you've acquired. In that case, keep doing the exercises in the same way just as often as before, but don't increase the weights.
Shauna S. Roberts, PhD, is a science writer in New Orleans, La.
COPYRIGHT 2002 American Diabetes Association
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