Resistance Training Is Finally Getting the Respect It Deserves for Health and Longevity

Lifting weights is now recognized as good for more than “just” making muscle.

For decades, aerobic exercise was regarded as the primary form of exercise you should do for cardiovascular and other health benefits. Heck, that’s why endurance type exercise such as walking, biking, and running are commonly referred to as “cardio.” The physical activity guidelines have traditionally emphasized aerobic exercise for health, even though researchers have been talking about resistance training being good for your heart for more than twenty years.

“Resistance training not only can improve or maintain muscle mass and strength, but also has favorable physiological and clinical effects on cardiovascular disease and risk factors.” American Heart Associaltion

Now, finally, the new American Heart Association (AHA) scientific statement in Circulation makes the argument that, “Resistance training not only can improve or maintain muscle mass and strength, but also has favorable physiological and clinical effects on cardiovascular disease and risk factors.”

The statement is an update from 2007, and summarizes the benefits of resistance training alone or in combination with aerobic training to improve traditional and non-traditional cardiovascular disease risk factors, especially since resistance exercise may be as effective as aerobic exercise for the prevention of chronic disease and improving health and lifespan.

That message needs to be amplified, because just 28 percent of US adults and only 20 percent of women lift weights at least twice a week, as recommended. Moreover, the official physical activity guidelines should put more emphasis on promoting strength training. Currently, the guidelines recommend 150 minutes of moderate intensity aerobic activity every week (~22min/day), along with activities that maintain or increase muscular strength and endurance at least two times per week. As this AHA statement illustrates, emerging evidence is now showing the need for emphasizing the importance of resistance training for overall health and longevity. 

Where Strength Training Shines

First, let’s state the obvious: resistance training is essential to avoid the reduced functional capacity that comes with age-related sarcopenia, or the loss of muscle that comes at a steady clip from our mid-30s on, and for women can accelerate during perimenopause where we can lose up to 10 percent of our appendicular muscle mass during that transition alone.

Lower muscle mass diminishes our functional ability, increases our risk for falls, and lowers our quality of life. Weaker muscles also make it harder to have the strength, power, and energy to perform aerobic exercise activities.

But that’s just the most obvious resistance exercise benefits. Other health benefits include:

Cardiovascular Disease  

A 2022 study found that any amount of strength training reduced cardiovascular disease mortality by 19%. And a 2019 study of more than 12,500 participants reported that those who performed at least one hour of strength training per week had a 40 percent to 70 percent decreased risk of cardiovascular disease events like heart attack or stroke, independent of the aerobic exercise they did.  

Specifically, the AHA statement reports that resistance training can reduce resting blood pressure in healthy adults, as well as those with prehypertension, hypertension, and elevated cardiometabolic risk. In fact, the evidence suggests that resistance training yields resting systolic blood pressure benefits similar to antihypertensive medications. 

Resistance training has a favorable, though modest, beneficial impact on total cholesterol, triglycerides, and high-density lipoprotein (HDL) cholesterol. It can help improve body composition and slow or prevent weight gain overtime by increasing or maintaining muscle mass, reducing fat stores, and increasing resting metabolic rate. It also contributes to improvements in cardiorespiratory fitness.

Metabolic health

Resistance training significantly improves insulin sensitivity, which makes it easier to manage your blood sugar, lowering your risk for diseases like type 2 diabetes. Research on people with type 2 diabetes has shown that resistance training is an effective exercise strategy for decreasing HbA1c—a marker of your average blood glucose levels over the past two to three months. 

The AHA statement reports that regular resistance training is associated with a 17 percent lower incidence of diabetes compared with no strength training. 

Overall health and longevity

There’s a growing body of research on all the ways resistance training is good for myriad aspects of health and longevity. A few highlights include:

• Cancer: A systematic review and meta-analysis of 10 studies showed that compared to doing no resistance training, performing any resistance training was associated with a 14 percent decrease in cancer mortality.
• Brain health: Resistance training triggers a cascade of muscle-based proteins that help generate new connections in the brain. It also stimulates the release of a hormone called irisin that improves brain function and health. 
• Longevity: That same systematic review and meta-analysis mentioned above also found that about 60 minutes of resistance training per week was associated with an all-cause mortality risk reduction of up to 27 percent. 

For Women Specifically…

Women especially need to stay on top of their skeletal health, since we can lose up to 20% of our bone mass in certain sites in the years leading to and around menopause, and 35% to 50% of women have low bone mass by age 50. Resistance training is essential for supporting strong bone density.

As the AHA statement reports, resistance training improves bone mineral density in the femoral neck and lumbar spine in pre- and postmenopausal women. It’s especially effective when combined with other weight-bearing, high impact activities like tennis and jumping rope. 

Finally, strength training is good for building a better body image, which is something many women (and men!) can benefit from!