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Associations of Resistance Exercise with Cardiovascular Disease Morbidity and Mortality

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https://insights.ovid.com/crossref?an=00005768-900000000-96766

Associations of Resistance Exercise with Cardiovascular Disease Morbidity and Mortality

Abstract

Purpose

Resistance exercise (RE) can improve many cardiovascular disease (CVD) risk factors, but specific data on the effects on CVD events and mortality are lacking. We investigated the associations of RE with CVD and all-cause mortality, and further examined the mediation effect of body mass index between RE and CVD outcomes.

Methods

We included 12,591 participants (mean age 47 years) who received at least two clinical examinations 1987-2006. RE was assessed by a self-reported medical history questionnaire.

Results

During a mean follow-up of 5.4 and 10.5 years, 205 total CVD events (morbidity and mortality combined) and 276 all-cause deaths occurred, respectively. Compared with no RE, weekly RE frequencies of one, two, three times or total amount of 1-59 minutes were associated with approximately 40-70% decreased risk of total CVD events, independent of aerobic exercise (AE) (all p-values <0.05). However, there was no significant risk reduction for higher weekly RE of more than four times or ≥60 minutes. Similar results were observed for CVD morbidity and all-cause mortality. In the stratified analyses by AE, weekly RE of one time or 1-59 minutes was associated with lower risks of total CVD events and CVD morbidity regardless of meeting the AE guidelines. Our mediation analysis showed that RE was associated with the risk of total CVD events in two ways: RE had a direct U-shape association with CVD risk (p-value for quadratic trend <0.001) and RE indirectly lowered CVD risk by decreasing BMI.

Conclusion

Even one time or less than one hour/week of RE, independent of AE, is associated with reduced risks of CVD and all-cause mortality. BMI mediates the association of RE with total CVD events.

Popular Press: https://www.msn.com/en-us/health/fitness/less-than-one-hour-of-weightlifting-a-week-may-reduce-risk-of-heart-attack-and-stroke/ar-BBPHbSz?OCID=ansmsnnews11

Less than one hour of weightlifting a week may reduce risk of heart attack and stroke

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New US research has found that lifting weight for less than an hour a week could reduce the risk of heart attack or stroke by 40 to 70 percent.

Carried out by researchers at Iowa State University, the new large-scale study looked at 12,591 participants with an average age of 47 years.

 

The researchers assessed the participants' level of resistance exercise using self-reported questionnaires, and investigated the possible association between this type of exercise and three health outcomes: cardiovascular events such as heart attack and stroke that did not result in death, all cardiovascular events including death, and death from all causes. 

The findings, published in the journal Medicine and Science in Sports and Exercise, showed that resistance exercise reduced the risk for all three health outcomes included in the study. 

Engaging in a total of 1 to 59 minutes of weightlifting per week, split over either one, two, or three sessions, was associated with a 40 to 70 percent reduced risk of experiencing a cardiovascular event.

Similar results were also found when looking at the risk of death from cardiovascular events and death from all causes.

However, four sessions a week or spending more than an hour weightlifting did not bring any additional benefit, the researchers found.

"People may think they need to spend a lot of time lifting weights, but just two sets of bench presses that take less than 5 minutes could be effective," said author Duck-chul Lee.  [Gordo: This is what I've suspected for years, that you really only need about 5 minutes of exercise per day if done right, particularly so if you are already a very healthy eater who doesn't need to burn off excess calories with exercise]

The results, which are some of the first to look at the relationship between resistance exercise and cardiovascular disease, also showed that benefits of the exercise are independent of running, walking or other aerobic activity, meaning that even if individuals do not meet the recommended guidelines for aerobic physical activity, weight training alone may be enough to lower the risk of cardiovascular diseases. 

The researchers noted that resistance exercise is not as easy to incorporate into a daily routine as aerobic exercise, with Lee suggesting a gym membership to give individuals access to weights and more options for resistance exercise. In a previous study Lee also found that people with a gym membership exercised more.

However, although the current study did look specifically at use of free weights and weight machines, such as those found in a gym, Lee added that any resistance exercises or muscle-strengthening activities will still bring benefits.

"Lifting any weight that increases resistance on your muscles is the key," Lee said. "My muscle doesn't know the difference if I'm digging in the yard, carrying heavy shopping bags or lifting a dumbbell."

Edited by Gordo

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BMI mediates the association of RE with total CVD events.

That sounds like a lame conclusion, as we have discussed in other threads.

If low BMI is a proxy for lower adiposity then the sentence would be correct, but we know that RE can substantially increase BMI by increasing muscle mass. Also, if RE yields benefit regardless of aerobic exercise, it cannot be just an adiposity matter, since AE tends to be pretty effective in decreasing adiposity.

Unless the 'mediation' is related to a BMI value wich is  an optimum between adiposity and muscularity.

I wrote the above comments without reading the original article

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Engaging in a total of 1 to 59 minutes of weightlifting per week, split over either one, two, or three sessions, was associated with a 40 to 70 percent reduced risk of experiencing a cardiovascular event.

Tell me what you wish but I find very hard to believe that 1 minute of RE per week is going to provide measurable results. 59 minutes is  a little different, but probably it should be split in 2 30-minutes workouts...

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18 hours ago, mccoy said:

Tell me what you wish but I find very hard to believe that 1 minute of RE per week is going to provide measurable results. 59 minutes is  a little different, but probably it should be split in 2 30-minutes workouts...

But for those choosing the 1 minute option how do they optimize it?  A single brutal weekly session or should it be three 20 second sessions each followed by a day of recovery?

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Todd,

Are you asking this question because you are considering how to optimize your own resistance training routine?

If you are, I believe that a very simple & basic resistance training routine will provide much more than 60s per week of actual lifting.

 I personally try to get maximum results for minimum time training and work out 3days per week; each day I do 1 upper body pulling exercise, 1 upper body pushing exercise and 1 lower body movement for 25-30 total reps each (as heavy as I can for example 5 sets, 5 reps each)

example:

Monday

5x5 chin-ups, dips, deadlifts

Wednesday

5x5 bench press, rows, squats

Friday

5x5 upright rows, standing push- press, lunges

This takes approximately 20-25 minutes each day with plenty of rest,

Clinton

 

 

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9 hours ago, Clinton said:

Are you asking this question because you are considering how to optimize your own resistance training routine?

It was a joke.  I considered asking how much of a 20 second workout should be devoted to warm up  and cool down but thought better of it.

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Sadly, this study is almost worthless. It's entirely possible that the stated benefits are real, i.e. RE lowers your CVD/all cause mortality, but this particular study does not prove it. There seems to be very little effort expended to reduce confounders and reverse causality - it's a lot of conjecture and opinion extrapolated very far from the "association". I do believe there are all kinds of benefits to RE, and a health conscious person would do well to incorporate some in addition to AE, but this study is not the reason.

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On 11/16/2018 at 4:13 PM, Todd Allen said:

But for those choosing the 1 minute option how do they optimize it?  A single brutal weekly session or should it be three 20 second sessions each followed by a day of recovery?

Todd, I believe the only reasonable way to optimize that single minute would be to use a machinery which contracts time, so that we can brutally exercise in 20 minutes subjective time which would result, by the hypothetical physical device, in 20 brutal seconds objective time.

 

Edited by mccoy

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On 11/17/2018 at 4:07 PM, Clinton said:

... I personally try to get maximum results for minimum time training and work out 3days per week; each day I do 1 upper body pulling exercise, 1 upper body pushing exercise and 1 lower body movement for 25-30 total reps each (as heavy as I can for example 5 sets, 5 reps each)

example:

Monday

5x5 chin-ups, dips, deadlifts

Wednesday

5x5 bench press, rows, squats

Friday

5x5 upright rows, standing push- press, lunges

This takes approximately 20-25 minutes each day with plenty of rest,

Clinton

 

 

That's a good example of optimization. Presently I wouldn't be able to follow that schedule for many reasons though. For those of us who have some age and related afflictions, we must train around injuries and nagging pains. Those who are lucky, can train as they wish, but the wiser ones avoid the exercises which impinge too much on joints and spine.

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On 11/15/2018 at 3:19 PM, mccoy said:

Tell me what you wish but I find very hard to believe that 1 minute of RE per week is going to provide measurable results. 59 minutes is  a little different, but probably it should be split in 2 30-minutes workouts...

For most people, I would recommend 2 30-minute workouts.  And I believe that this would be idea ROI for most people.

HOWEVER, I think this survey is another one that separates out people who are actually physically unable to do any exercise or else so inured to their extreme sedentary lifestyle from those who make any level of effort higher than that.  You're getting the people who can't even be bothered to lie that they exercise.  The benefits for the people at the low end are too high and the high end are too low for the 1-59 min interval.

For people who are interested in this minimum time/max rewards, Ice Cream Fitness or push/pull/legs is good.  I don't actually like deadlifts with a standard bar for beginners, though, because they ALWAYS get hurt, so I strongly, strongly prefer trap bar deadlifts.

I also cannot recommend strongly enough to STAY AWAY FROM THE SMITH MACHINE.  The biomechanics are terrible.  It's incredibly hard to injure yourself doing a free weight squat and very easy on any kind of squat machine.  The load MUST move laterally to prevent injury.  It must.

I personally have recently blended the Big Three lifts and some other real lifts that I was already doing into Bret Contreras' Strong Curves routine--or, if you look at it another way, I've added more butt work into a general weightlifting splits workout--because as long as I'm working out, I'd like to look hawt, too.  Very scientific approach, there.  But my WtHR is going to be killer.  😉  Goal is 38-25-35/6 at a BMI of 19-20 and BFP of 15-20%, because, sadly, it seems that my waist will never be as small as it was pre-kids as I still have a slight ab wall separation.

Edited by Genny

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I'd like to know at what point does exercise diminish visceral fat - what kind of exercise, how long, at what intensity etc. - I have inherited from my father a slight tendency to accumulate belly fat, and it's really noticeable - the moment I let up on CR even slightly, the very first place a slight bump forms is right below my chest. This happens every year when I go on a month long vacation where I'm off CR and exercise. I gain virtually no fat anywhere else after such a short break, but I figure it's all there in the form of visceral fat. As far as I know, other than surgery, exercise is the only way to keep visceral fat down. The nasty part is that visceral fat is the very first to expand too - so keeping it down means keeping all body fat down even more.

That said, I do wonder if there is some form or protocol of exercise that would target *visceral* fat specifically or is it all really non-selective, and a simple matter of calories added vs calories expended.

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17 hours ago, TomBAvoider said:

That said, I do wonder if there is some form or protocol of exercise that would target *visceral* fat specifically or is it all really non-selective, and a simple matter of calories added vs calories expended.

I haven't seen anything that would suggest one can target visceral fat or any other fat depot via exercise.  I suspect genetics and hormones largely control fat deposition and release from most of the various tissues where fat can accumulate, the liver maybe being an exception as it appears to be affected by a wide range of substances perhaps most notoriously ethanol.

If blood sugar spikes contribute to visceral fat deposition one might adopt exercise practices to stabilize blood sugar.   I have found high intensity strength training before meals with carbohydrates and low intensity aerobic exercise after those meals lower the amplitude and duration of elevation in post prandial blood sugar.

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Good tips, Todd, thank you. I used to do 5-7 minutes of intense lifting just before meals (easy with just two meals a day) exactly with the idea of getting my muscles primed to uptake glucose, and my sugar readings were never better. Somehow I fell off that habit, and now I'm thinking I should get back to it.

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