Are You Flabby and Frail?


Americans are losing the war on fat. This generation of kids is the first whose life expectancy is less than their parents and it is because of obesity and obesity-related diseases.

Yet ask the average person what to do about it, and they all seem to have an answer: "I know, I need to eat less and exercise more" is the common refrain. Unfortunately, even that simple bit of wisdom is not so straightforward, or even true in many respects.

I will leave the eating to another article, but as for exercise, the statistics are dismal.  A study in the "Journal of American College of Sports Medicine 2008" showed that in people between the ages of 16-19, only 5.6% are getting adequate exercise, while only 3.5% of people ages 20-59 get adequate exercise. At 60+ years, statistics drop to only 2.4%.

Obesity is an epidemic in the United States with more than one-third of Americans considered obese and another one-third overweight. The news is even worse when you consider actual body fat. One recent study found that BMI-defined (Body Mass Index) obesity was present in 19.1% of men and 24.7% of women, but that obesity, as measured by body fat percentage, was present in 43.9% of men and 52.3% of women!

Starting in our 40s, we begin to lose muscle mass. The average person loses about six pounds of muscle per decade from the 40s onward. This equates to about a 3-5% reduction in the body's metabolism per decade. 
The basic problem for most overweight and obese people is too much fat and not enough muscle.  As a result, their metabolism is too low and they just don't burn enough calories. By dieting or restricting calories, they may lose fat, but they will also lose muscle and further reduce their metabolism. To prevent this muscle loss, resistance training is a fundamental part of any weight loss program. 

Resistance training does not take as much time as you might think. It is not aerobic but rather anaerobic exercise, so by definition you are fatiguing the muscle within 60-90 seconds. To do so, you need adequate weight. An ideal weight to build muscle is 70-80% of the maximum weight you can lift one time. For most, this equates to a weight you can lift 8 to 12 times before having to put it down. However, when starting a weight program, work with a weight you can lift about 16 times, which generally equates to about 60% of your maximum.

As the goal is to build muscle to increase your metabolism and muscle mass, you should work out all areas of your body. This includes your legs, gluts, abdomen, chest, arms, shoulders and back. You can start with one set per muscle group and start with about 16 reps. As you improve, work out in the 8-12 reps zone. Then as you get stronger, add a second and then a third set. You generally should give yourself a minute or two between sets to rest and allow your muscles to recover. When you can do three sets of 12, increase your weight by about 5% and go back to one set. This double progression of sets, then increasing weight and returning to a single set will help minimize your risk of injury.

When lifting, be sure not to do too much weight that you cannot exercise the full range of motion of your joint. By completing the full range of motion, you will exercise the entire length of the muscle and at the same time fully stretch the opposing muscle. Exhale while you are contracting the muscle/lifting the weight to help keep your blood pressure under better control.

When you lift weights, you actually are not building muscle, but rather tearing it apart.  Your muscles then regenerate stronger than before, and as such, you need to give them time to recover. It takes about 48 hours for muscle to fully recover, so for most, lifting three days a week is the most you should do resistance training. Lifting twice a week, when done properly, will give about 90% the results of three days a week. 

Nutrition is important when doing resistance training. In one study, folks drinking or eating about 20-30 grams of protein with 20-40 grams of carbohydrates either right before, during, or after their resistance training lost 80% more fat and gained 40% more muscle during a six month period. This might be a Greek yogurt before and after your weight training or a whey protein smoothie or shake.

You can do resistance training at a gym or at home. Free weights, your own body weight, bands, or machines are all ways to do resistance training. As with everything in life, common sense prevails, so if you have a medical condition or other impediments to resistance training, then discuss this advice with your doctor prior to starting. Hiring a trainer to help with technique would be helpful, though you might also have a friend who can get you on the right track. Plus, working out with a partner can keep you both motivated.

So, if you are overweight or obese, or if you are over 40 and losing muscle, resistance training is an important and often overlooked tool in your overall health. Grow your muscles and feel younger next year! 

Dr. Clark Trask is Board Certified by both the American Board of Family Medicine and American Board of Bariatric Medicine. He grew up on St Helena Island and has practiced medicine in Alaska, Nepal, New Zealand and Asheville, N.C. prior to returning to Beaufort with his family. He practices family medicine and weight loss medicine at his office on Ribaut Road across from Beaufort Memorial Hospital.

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