As I become more involved with Preventative Health Sciences, I am finding that many physicians are overlooking the importance of resistance training in weight loss management. It seems that most patients are not educated on its fundamental importance. I found in an article recently published in Circulation, that a new AHA scientific statement summarizing recommendations for resistance training in people with and without cardiovascular disease (CVD) has been developed. I am hoping that this will serve as a reminder to clinicians that there are "singular" benefits to improving muscular strength in addition to regular aerobic exercise.

Despite this being the second set of recommendations on this topic to come from the American Heart Association (AHA), physicians may still overlook resistance exercise — lifting weights, or exerting force against resistance — as part of cardiovascular (CV) fitness regimen.

Telling someone to exercise typically suggests to the patient that they should be doing more walking. Unfortunately, I don't think resistance training is frequently thought of as part of an overall exercise program.

The statement of recommendations that I am referring to was published in a rapid access issue of Circulation, July 16, 2007, entitled: Resistance Training Additive to Aerobic Exercise.

The statement reviews the health benefits of resistance training and its impact on the CV function. It also summarizes the role of resistance training in modifying CVD risk factors, its benefit in specific CVD populations, and provides recommendations on evaluating patients prior to starting a resistance training regimen and suggestions for how such a regimen could be prescribed.

The AHA statement compares the effects of aerobic activities and resistance training on different parameters, noting that some clinicians may be unaware of the differential effects. For example, while aerobic exercise can have moderate effects on percent body fat, compared with merely a small effect of resistance training, resistance training has moderate effects on lean body mass, and major effects on muscle strength, while aerobic exercise has no effect, and minimal effects, respectively. By contrast, both aerobic and resistance exercise produce similarly small effects on high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, while aerobic exercise has greater effects than resistance training on triglycerides.

Importantly, both forms of exercise can have similar effects on quality of life. The importance of resistance training is now fairly well recognized in cardiac rehabilitation programs, but its benefits are less commonly appreciated in primary prevention.

Proper instruction and technique is essential for anyone beginning resistance training for the first time, but it is especially important for people with existing cardiovascular disease. Patients who come into cardiac rehabilitation programs typically get that kind of instruction, but people who are not participating in those formal kinds of programs should get in touch with an exercise specialist, or a physical therapist to provide some input on how to be doing resistance training properly. And the key there is that patients who do have cardiovascular disease need to identify themselves as such, so people don't assume they are healthy and give them instructions that would be inappropriate.

Of note, in all of the research to date, there are almost no reports of significant adverse effects of resistance training, although these were all supervised, controlled studies where risk is minimized.

I thought this was very interesting. Not only do I find a need to educate the general public regarding the importance of resistance training, but there is also a need to educate my collegues so they can spread the word.

If you are interested in a specialized program for resistance training and nutritional guidelines, contact Preventative Health Sciences at 515/225-2578. You can also find information at www.phsglobal.com