At Full Strength
by Women’s Brain Health Initiative:
HEAVY LIFTING FOR BRAIN HEALTH.
The benefits of exercise on a person’s overall health have been well-documented over the years, but recently, more attention has been paid to the specific benefits strength training can have on a person’s brain health and lifespan.
Recent research conducted by Dr. Jessica Gorzelitz and colleagues and published in September 2022 in British Journal of Sports Medicine, found that adults who engaged in weightlifting exercises specifically enjoyed an overall lower risk of mortality as it relates to all-cause and cardiovascular-specific mortality (cancer excluded).
The study, entitled “Independent and Joint Associations of Weightlifting and Aerobic Activity with All-cause, Cardiovascular Disease and Cancer Mortality in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial,” followed nearly 100,000 people across the United States for 9.6 years through 2016. More than half (52.6%) of adults studied were women and the mean age of the participants was about 71 years old.
Interestingly, the biggest benefit came to those who engaged in both aerobic and weightlifting workouts at least twice a week. When looking at cancer mortality specifically, the study found a lower mortality rate only when weightlifting was combined with aerobic activity.
“Our results show that weightlifting is uniquely associated with lower mortality and that doing both types of exercise may provide greater mortality benefit,” Dr. Gorzelitz, the lead researcher behind the study and Assistant Professor of Health Promotion at the University of Iowa, recently told Mind Over Matter®.
Adding weightlifting to one’s physical activity routine, even for those who are aerobically active, is important for better health and longevity.
While the findings are promising, Dr. Gorzelitz said more studies need to be done to better understand the full potential of a strength-training regimen.
“Previous evidence showing mortality benefits associated with muscle strengthening exercises (like weightlifting) is quite limited. One of the challenges that this project is addressing is the lack of evidence about weightlifting specifically, instead of the lumped category of muscle strengthening exercise or activity,” she said.
“It is appropriate and necessary to issue caution with our findings. No one study stands alone, and there must be replication of any scientific findings to strengthen our confidence in the results.”
STRENGTH TRAINING, AEROBICS PACK HEAVIEST PUNCH
While studies on weightlifting are scarce, there are others that look at the benefits of resistance training outside of aerobic activity that show similar results in terms of its positive impact on a person’s lifespan.
In July 2022, Japanese researchers released their findings after conducting a meta-analysis of 16 cohort studies that explored the impact of muscle-strengthening exercises on the health of adults (18 years and older) without severe health conditions. Their report was published in British Journal of Sports Medicine.
30 TO 60 MINUTES OF MUSCLE-STRENGTHENING ACTIVITIES PER WEEK, SHOWED AN ASSOCIATED 10 TO 17% LOWER RISK OF ALL-CAUSE MORTALITY, CARDIOVASCULAR DISEASE, TOTAL CANCER, DIABETES, AND LUNG CANCER.
The study also found that up to 60 minutes of resistance training a week led to a “large risk reduction” for diabetes. Similar to Dr. Gorzelitz’s study, the analysis found that when muscle-strengthening exercises were combined with aerobic activity, there was an even lower risk of mortality.
However, the researchers echoed calls for a deeper investigation around the benefits of strength training. “Given that the available data are limited, further studies – such as studies focusing on a more diverse population – are needed to increase the certainty of the evidence,” the analysis said.
Michelle Dukowski, an avid weightlifter, co-founder of RedLeaf Fitness and a leader in the wellness industry for the past 15 years, says the studies that have been done lend immense credibility to what health experts have been saying for years.
“When someone is focused on strength training, it requires them to lead a certain lifestyle that is conducive to building muscle: they tend to prioritize sleep, nutrition, stress management, and regular exercise.”
Dukowski added that there are studies that show the more muscle one has, the less likely they are to develop type 2 diabetes, abdominal (visceral) fat, heart disease, and high blood pressure, which are some of the leading causes of death in North America.
STRONG BODY, STRONGER MIND
While there are few studies looking at the impact of resistance training on an adult’s lifespan, there are an increasing number of studies on the impact of weight training on a person’s overall health, particularly around matters of the brain.
Dr. Teresa Liu-Ambrose, Tier 1 Canada Research Chair in Healthy Aging and Professor in the Faculty of Medicine at the University of British Columbia, has been studying the correlation between strength training and the brain’s cognitive capabilities since 2007.
In 2010, Dr. Liu-Ambrose and colleagues published the findings of a 12-month randomized controlled trial on women aged 65 to 75 years old in Archives of Internal Medicine. The study, entitled “Resistance Training and Executive Functions,” found that resistance training even once a week “significantly improved” older women’s cognitive abilities to regulate behaviour.
The study also found that resistance training twice per week could reduce the progression of pre-existing disease in the small blood vessels of the brain, which may delay the onset of cognitive impairment.
Furthermore, the researchers discovered a correlation between increased walking speed and enhanced cognitive control, suggesting that cognitive abilities are related to how well a person moves. It also noted that faster walking speed is a predictor of “substantial reduction in mortality.”
In an interview with Mind Over Matter®, Dr. Liu-Ambrose said she focused on women because at that point, very few people had looked at studying the impacts of resistance training and she wanted to look at a homogenous group to be able to confidently determine if there was in fact an impact on the brain.
THERE IS EVIDENCE TO SUGGEST THERE ARE SEX DIFFERENCES IN EXERCISE’S EFFECT ON COGNITIVE CAPABILITIES.
That’s particularly important when considering what we do know about women’s cognitive issues as they age. “Other studies have shown evidence to suggest that once females have an onset of cognitive impairment, they actually do decline more rapidly as compared to males,” she said.
“It’s interesting because in many ways, women are kind of protected beforehand with the effects of estrogen on the brain, but then something happens. After perimenopause, we are more vulnerable.”
However, regardless of whether the subject is a woman or a man, resistance training positively strengthens the mind, a more recent study concluded.
The study, involving Dr. Michael Valenzuela and colleagues, entitled “Hippocampal Plasticity Underpins Long-term Cognitive Gains from Resistance Exercise in Mild Cognitive Impairment (MCI),” was published in Neuroimage: Clinical in 2020.
Notably, it found for the first time that resistance training can protect hippocampal areas of the brain responsible for memory function for up to one year. With Alzheimer’s disease, these particular subareas are susceptible to volume loss and therefore declining memory function.
It also found that computerized cognitive training did not lead to long-term cognitive improvements when coupled with a strength training program. That result surprised Dr. Valenzuela.
“We had expected to see the greatest benefit when combining strength training with computerized brain training, but this turned out in some respects to be worse than either strength training or brain training by itself!” he said in an interview with Mind Over Matter®.
Calling dementia a “great challenge to modern society,” researchers behind the study warn more exploration should
be done to further understand the potential benefits of
strength training.
“Future work will need to establish just how long-lived these outcomes are and whether they are sufficient enough to delay cognitive decline,” the study concludes.
STRENGTH TRAINING SHOULD BE PART OF TREATMENT PLAN
Dr. Valenzuela, who is a visiting professor at the Centre for Healthy Brain Ageing, University of NSW Sydney, an expert advisor at the World Health Organization, and co-founder and CEO of Skin2Neuron biotech company, said there is still a role for strength training with people who have advanced cognitive impairment.
“Generally speaking, exercise and physical activity takes on a different role after diagnosis,” he said. “Before diagnoses, as we and others have shown, it has a proven role in prevention, risk reduction, and protecting the brain from shrinkage. After diagnosis, it remains important but more from a quality-of-life perspective and as a way of helping to manage agitation and anxiety.”
BOTH DR. VALENZUELA AND DR. LIU-AMBROSE BELIEVE THE REAL POTENTIAL LIES WITH THE HEALTHCARE SYSTEM MAKING STRENGTH TRAINING AN INTEGRAL PART OF A TREATMENT PROGRAM FOR SENIORS.
“Policymakers need to take seriously the link between physical activity and exercise and long-term brain health,” Dr. Valenzuela said. “Around the world there is an opportunity to help avert millions of people developing dementia over the coming decade. In my view, high-income countries need to move beyond awareness and education campaigns to drivers of concrete behavioural change.”
MENTAL HEALTH, SELF-CONFIDENCE HUGE BENEFIT OF STRENGTH TRAINING
In the meantime, fitness leaders such as Dukowski see older adults coming into the gym on their own to improve both their overall physical health and mental health.
“Particularly with clients who are in the 50-plus age category, life begins to change,” she said. “The kids have left home, they are starting to think about retiring or they have just retired and are trying to redefine themselves and their purpose. Their sense of identity begins to change and strength training is one of the best places people can go to because it helps them build an identity outside of those things. At the gym, they can become someone who is physically capable and mentally capable of doing hard things in life.”
One of her clients, Donette Chin-Loy Chang, refocused her energy on fitness after her husband, well-known Canadian philanthropist Raymond Chang, passed away. Chin-Loy Chang has always been athletic, but even as a child she turned to exercise to help focus her mind.
“I’ve always found the gym to be my saviour,” she said. “I see such a difference when I work out, not just in my body but in my brain. A lot of the physical stuff I do is to calm myself down.”
Outside of the gym, Chin-Loy Chang keeps busy with philanthropic projects, sitting on the board of the Toronto International Film Festival, and taking care of her 90-year-old mother. Keeping busy gives her a sense of control but she said being in the gym is the mental exercise she needs to remember that she actually is in control.
At 103 lbs, Chin-Loy Chang can pick up 183 lbs on a sumo deadlift and she can back squat 85-90 lbs. At 67 years old, she is believed to be the oldest member at RedLeaf Fitness, and often, can give the average 30-something member a run for their money when it comes to fitness.
“Lifting 183 lbs is a mental game and I like to challenge myself all the time,” she said. “I’m experienced enough to know that I can tell myself to lift that weight. It strengthens my brain because I feel invincible.”
Chin-Loy Chang said as she gets older, she has less of an appetite for risk and works out to keep her brain sharp as well as mentally fit.
“In my mind I’m always too far ahead, I don’t live in the moment. But strength training is in the moment and for me not to get injured, my brain needs to get engaged,” she said. “Muscle has memory and the brain is a muscle. It really is the last frontier.”
POPULAR MISCONCEPTIONS ABOUT STRENGTH TRAINING
Weightlifting, strength training, and resistance workouts all help build muscle and improve our overall health, but there are many preconceived notions about these types of exercises that fitness experts want to debunk.
Weight, strength, and resistance training are generally used interchangeably and refer to the same thing – using an external load to get stronger. It is the rep scheme that determines building strength versus size, but the classification of “weight/strength/resistance” all refers to the same process.
“Until recently, strength training is something that was perceived to be limited to certain environments, such as athletes training for a sport, professional bodybuilders, and the like,” explained Michelle Dukowski, co-founder of RedLeaf Fitness, a CrossFit gym in Toronto.
“It was generally thought to be more socially acceptable for people – especially older women – to engage in cardio training. Now, there has certainly been a public shift and it is becoming more ‘normal’ to see average people entering the weight room. Hopefully the research on the benefits of strength training will continue to encourage more people to give it a try.”
According to Dukowski, who has been a leader in the fitness industry for the last 15 years, the three biggest misconceptions that people have about strength training are:
• lifting weights will add too much bulk;
• the exercises are too difficult to achieve; and
• strength training can lead to injury.
Dukowski says most of people’s concerns are rooted in fear rather than facts. She explains that weightlifters who look “too bulky” generally have this as a specific, deliberate goal and train for years to look like that.
“I tell them, ‘We aren’t training in a way that will produce that result,’ and then I walk them through what their training will look like and help them understand the difference,” she said.
For people who lack confidence in their skills at the gym or worry about getting hurt, Dukowski reminds them that progress is what matters.
“When people have a goal that they can’t see themselves accomplishing, I tell them, ‘Right now you can’t but that doesn’t mean you won’t soon be able to!’” she said. She then asks about the movements they are feeling the least confident about and explains the steps they will take to build their strength up to do it and the techniques they will learn to help avoid injury.
“We take a big goal that seems unattainable and make it smaller and more manageable,” she said. “It helps them see that even though they can’t do it yet, there is always a path to get there.”
TIPS AND TRICKS ON HOW TO STRENGTH TRAIN AT HOME
While working out a gym gives people access to experts and equipment, many critical strength training exercises can be done at home with no equipment at all.
Older adults should focus on functional movements that can help their daily routines.
“Focus on the movements you do in your day-to-day world, outside of the gym,” Michelle Dukowski, co-founder of RedLeaf Fitness said. “For example, if you are taking care of your elderly parents at home, practice lifting heavy objects in case you have to help lift up one of your parents.”
Here are other tips and tricks she shares with her clients:
Start slowly – Anything is better than nothing. Start with going for a walk or walking up and down the stairs several times in a row a couple of times a day. When watching TV, sit and stand ten times in a row. Even ten minutes of exercise is better than zero.
Watch instructional videos – When looking for new exercises to explore at home, look for videos that explain the movements well and demonstrate the correct form. The goal is to learn to move safely and focus on progress, not perfection, Dukowski said.
Work out in the morning – People who work out in the morning often report that they feel more focused and productive throughout the entire day but they also tend to make healthier lifestyle decisions throughout the day as well. “It’s a win right off the bat,” Dukowski said. “They are more likely to eat well, go to sleep early, etc. Plus, they are less likely to have something in their schedule interrupt their workout.”
Wear a heart-rate monitor – For older adults who have never strength trained, having a wearable device that measures a heart rate will let them know if they are working out at the right pace. If a heart-rate monitor isn’t available, Dukowski said there are other signs to look out for when working out. “Are you able to talk? Are you gasping for air? Do you feel light-headed? Take it slow at first and you will naturally increase your abilities,” she said.
Find a friend – Even when working out alone at home, it helps to have a friend to call for support and accountability, Dukowski said. “Find someone you trust. Pursuing fitness can open the door for vulnerable conversations about what you are going through right now. Having someone you trust to talk to can make all the difference.”