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What's So Good About Being Strong?

  • Writer: digitalflynn
    digitalflynn
  • Jul 2, 2021
  • 8 min read

Updated: Jul 4, 2021

Aesthetics is not the answer. The fitness world, with its good lighting and oily abs, and even the nutrition industry offensively adding protein to everything from water to bread may strongly suggest otherwise, but I promise it is not the (only) answer.


In athletes, greater muscular strength is associated with higher performance, e.g increased time to fatigue in cyclists and runners, as well as reduced risk of injury. For the non-athlete, muscular strength helps with bone density, increased performance at the gym or whatever movement we decide to partake in, reduced risk of injury and also ensures a better quality of life in later life. From our 30's, our core muscles naturally start to deteriorate. In our 50's, being able to get up from our chairs unassisted (core and leg strength & balance), or even opening a jar (arm strength) may determine how early/or late we lose our independent living. (Visser and Schaap, 2011)



Sarcopenia (which poetically translates to "poverty of flesh") is the age-related significant loss of skeletal muscle mass, strength and function. It occurs even in the absence of disease, affecting the neuromuscular system. Most healthy men and women >70 years may see a 20-40% reduction in strength compared to younger, healthy subjects. Handgrip strength has even been used as a predictor for mortality. A meta-analysis revealed that adults with a stronger handgrip (measured with an isokinetic dynamometer) had a 31% reduced all cause mortality risk, with a slightly stronger association in women than men. Similarly, adults with higher knee extension strength levels had a 14% lower risk of death. (García-Hermoso et al, 2018). This means, that low muscle strength levels may be considered as a risk factor for all cause mortality in adults. (Abramowitz et al, 2018; Li et al, 2018).



Studies on strength (the maximum force a muscle, or muscle group can generate a specific velocity) and power (which is also strength related, but it looks at the speed at which something is done) show a somewhat unsurprising association with muscle size. Fitness and strength training is something we're told to do once we're old enough to get a gym membership, and, as alluded to above, it becomes increasingly more important the older we get. Strength training doesn't necessarily have to entail heavy weight lifting if you're really averse to it (and if you do enjoy it, you probably don't need to hear any more preaching of its benefits). Other strength and resistance activities include: pilates, yoga, calisthenics, hill walking, climbing stairs and even activities such as gardening, especially if it involves lots of shovelling. (Westcott, 2012). It's beneficial for our hearts, brain and mind and yes, calorie burning..that can be a benefit too. At a minimum, we should aim to do strength-based activities twice a week.


Additionally, diet plays a role. Our food intake reduces around 25% between 40-70 years old. Older adults may eat slower (particularly if there are oral and dental issues) and ingest smaller meals. This means, alongside fewer calories, fewer nutrients are being consumed. The main food components that may have an influence on developing sarcopenia are:


Protein

Essential for building muscle. It has recently been observed that in order for an anabolic response to be provoked in the skeletal muscle, the threshold concentration of circulating amino acids are needed, along with elevated concentrations of leucine (an amino acid found in eggs, red meat, poultry, salmon, chickpeas, brown rice, nuts, soybeans). However, increased protein intake also needs to be accompanied by weight or resistance activities. It's recommended to consume 0.8g of protein per kg of bodyweight. So if you weight 60kg, you want to consume just under 50g of protein a day. For older adults, similar to athletes, the recommendation is higher at 1.2-2kg of protein per kg of bodyweight. So if you're 60kg and >70years that intake should be between just over 70-120g of protein a day. (Baum et al, 2016). This is easier said than done, how many elderly people do you know who eat that much protein in a week, let alone a day? (This is where oral and dental health also plays a big role, some foods - such as meat - can be hard to chew. Oral health needs to be taken care of throughout our entire lifespan to prevent issues later on.) (Kim et al, 2013).


Vitamin D

This hormone may stimulate proliferation of muscle fibres, helping to improve and maintain muscle strength and physical performance. Deficiencies are more common in older people due to generally consuming less food and this can result in a breakdown of the type II muscle fibres. In some studies higher vitamin D status has been associated with greater muscle mass. (Remelli, 2019) (As mentioned in the Skin and Inflammatory Diseases post, it is recommended that everyone takes a vitamin D supplement, particularly from October to May). See the BDA's Vitamin D Fact Sheet for more informaiton on RDA's.


Dietary Fat

In some studies, supplementation of omega-3 fatty acids resulted in significantly higher peak torque (power) levels in knee extensors and flexors, plantar and dorsiflex muscles. in other studies that separated healthy adults into resistance training or resistance training + a diet supplemented with omega-3s found that whole body lean mass significantly increased ONLY in the resistance training + omega-3 supplemented diet. (Ganapathy and Nieves, 2020). See the BDA Omega-3 fact sheet for more information on RDA's.


Magnesium

Several studies have shown that dietary magnesium may play a significant role in the prevention of developing sarcopenia and osteoporosis in both men and women. Taking less than the recommended RDA may result in more fractures. (Welch et al, 2017). See the NIH fact sheet for more information on Mg requirements. (Welch et al, 2017)


Vitamin K

A cofactor for specific enzymes that activate proteins for bone growth and remodelling. A report that came out last year in the Journal of Nutrients looked at 8 published trials of vitamin K that evaluated the outcome of fractures and osteoporosis. There are many different forms and dosages of vitamin K (eg K1, K2) and whilst studies suggest its intake reduces fracture risk, it is unclear in what form or dose. Find it in leafy veg like kale and spinach, brassicas like cauliflower and broccoli, fish, liver, meat and eggs. (Fusaro et al, 2020; Tsugawa, 2020; Moore et al, 2020). Adults need approx 1 microgram (μg)of vitamin k per Kg of bodyweight, so if you weight 70kg, you need 70μg.


What about Calcium??

Shockingly, despite its association with vitamin D absorption and bone health, good quality studies on calcium supplementation and sarcopenia are stark. More research is clearly needed, but deficiencies cause osteopenia and consequently osteoporosis. The BDA has just released an updated Calcium Fact Sheet, which is worth reading for advice for both the public and healthcare advisors.


Women

I'm afraid we are significantly more affected here. Not only do we lose muscle mass after menopause, we gain body fat. We're also more at risk of osteoporosis. This just means we need to ensure our diet and exercise is carefully considered (particularly in relation to the above nutrients) and have fun with it.


Bodybuilders

There's a lack of research on the efficacy and safety on the diets of bodybuilders. Being strong won't necessarily make you healthier if there's a reliance on steroids or weight loss supplements such as Anavar. The extreme cutting and re-feeding cycles need to be explored more in clinical settings, but research has shown that there can be negative psychological effects, such as development of eating disorders and body dysmorphia. Women who adhere to having a severely low body fat% (<14%) may risk amenorrhea (absence of periods for >6 months), affecting fertility and bone health.


Vegans

A study published last year found a higher rate of total leg fractures in individuals on a pescatarian, vegetarian or vegan diet, compared to meat eaters (Tong et al, 2020). No significant differences were observed in wrist or ankle fractures. Diets that do not contain all food groups (protein, carbs, fats & sugars, fruit and veg, dairy products) can result in deficiencies. Individuals who choose not to eat animal products can still thrive, assuming they are aware of nutrient imbalances they may be facing. You can read more about how to have a healthy diet that excludes animal products from the BDA here.


To Conclude

Being strong does not have to be associated with wearing lycra, obnoxiously shaking protein shakes, or grunting gratuitously at the gym. It isn't just about how we look, whether our triceps are popping or if our abs are visible, it's about optimal functioning in every day life. At some point, being able to get out of our seats without pushing ourselves up or needing assistance will be a sure sign that our bodies are still doing well and that we can live without the need of worrying about having a fall, or not getting our jam jars open. We also don't need to compare our strength with others. it will vary between everyone depending on our gender, ethnicity and age. The only thing we can improve is our commitment to sustaining our exercise routines and a balanced diet.


This post is very "able-bodied" oriented. I have a huge gap in my knowledge when it comes to disabled bodies and the appropriate level of expectation when it comes to strength and resistance goals. All disabled bodies are different, just as able-bodies are. I am looking to learn about this further. In the meantime, if anyone has experience as a healthcare practitioner or personal trainer/physio working with disabled clients, let me know if you have any thoughts to share. Likewise, if you are disabled and would like to give your opinion, or maybe share your own tips for exercise, contact me at rosie@stemandpoise.com




References & Further Reading


















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