08/23/2012 04:04 pm ET Updated Oct 23, 2012

Weighty Medicine: Pumping Iron Comes of Age

There has always been a prejudice against weight training. Some holdover on the Cartesian mind-body dichotomy, a brain-or-brawn choice, which until relatively recently has been a haughty "brain, please" vote. Weight training was too tightly connected to body-building, not so long ago a fringe practice, advertised in the back of comic books for scrawny young boys tired of having the proverbial sand kicked in their faces. The ads always featured a not-so-subliminal reward of a beautiful bikini-clad beach babe who gawked admiringly at the physique of the fellow who had completed the strength-training program on offer.

Arnold Schwarzenegger did more to mainstream weight training, first with his bodybuilding competition victories, gym promotions ("You, too, can look like me,"), acting career, and finally as the ironic chairman of the President's Council on Physical Fitness and Sports under George H. W. Bush. His quite public history of steroid use unfortunately gave weight training a black eye and maintained its seedier reputation.

While "road work" had long been a practice of many athletes, jogging became a national pastime in the 60s and 70s. It was embraced by the educated and socially mobile as a fashionable fitness practice (it even spawned its own wardrobe) that had the wholesome patina of healthy living. The medical community fully endorsed running as a way of preventing the epidemic of heart disease.

Linguistic evidence of medicine's success in associating running and heart health was the public adoption of the nearly synonymous term "cardiovascular exercise."

A similar appreciation of the health benefits of weight training has only begun to emerge despite its equally potent effects. Clinical research has demonstrated that resistance training benefits everyone, from children to seniors.

It had been thought that children could not get stronger with weight training and were at great risk of injury. Both turn out not to be true. Kids can get stronger despite an absence of "bulking up" or hypertrophy. The increased strength derives from changes that allow the nervous system to interact more efficiently with muscle. Children using excessively heavy weight are vulnerable (as are adults), and should be instructed in appropriate technique. Often one's body weight is the optimal load for training at any age. Actually, studies have demonstrated a lowered risk of injury in sports when child-athletes have engaged in resistance training programs.[1]

At the other end of the spectrum, vast literature exists on the benefits of resistance training for seniors. In the absence of such exercise, most humans lose five pounds of muscle per decade after the age of 30. This causes a dramatic loss of strength in that population, which is preventable.[2]

The maintenance of strength achieved with weight training allows a higher level of functioning and capacity to remain autonomous into old age. Such exercise also improves the pain of osteoarthritis, slows bone loss protecting against fractures, decreases the incidence of falls, and increases metabolic rate thereby helping maintain a healthy weight.[2],[3]

A recent high profile, well-designed study extended the therapeutic domain of weight training. It dramatically decreased the risk of Type 2 diabetes. The study appeared in the August 6 online edition of the Archives of Internal Medicine.[4] Data from an ongoing prospective cohort study of 32,002 male health professionals aged 40 to 75 at baseline in 1986 was analyzed.

The investigators found that weight training for as little as one to 59 minutes per week reduced the risk for Type 2 diabetes.

The risk reduction was comparable to aerobic exercise, with risk reductions of approximately 35 percent and 50 percent for at least 150 minutes/week of weight training or aerobic exercise, respectively.

This represents an important finding from two perspectives. One, resistance training provides another viable intervention in the war on the epidemic of Type 2 diabetes that can increase the therapeutic yield of aerobic exercise. And two, for those individuals who are unable to commit to an aerobic exercise regimen (and that is a very large population), resistance training provides a good alternative.

For more by Paul Spector, M.D., click here.

For more on fitness and exercise, click here.


1. Behringer, M. "Effects of Resistance Training in Children and Adolescents: A Meta-analysis."
Pediatrics. Vol. 126 No. 5 November 1, 2010 pp. e1199 -e1210

2. Liu CJ, Latham NK. "Progressive resistance strength training for improving physical function in older adults (Review)." The Cochrane Database of Systematic Reviews 2009, Issue 3.

3. "Resistance Training: A Review of the Literature," National Academy of Sports Medicine

4. Grontved A, Rimm EB, Willett WC, Andersen LB, Hu FB, "A Prospective Study of Weight Training and Risk of Type 2 Diabetes Mellitus in Men." Arch Intern Med., Aug 6, 2012