Strength training plays a significant role in preserving the quality of life amongst ageing women, yet it is often the most neglected form of exercise amongst this demographic; with many women opting for alternatives such as running, pilates, yoga or swimming. Although, these forms of exercise have their benefits, we are going to explain why at The Health & Fitness Lab we believe strength training is the most effective form of exercise for women over 40 by focusing on 7 key benefits.
1.) Improved Bone Density
Osteoporosis is a common concern for women over 40 years old, with over 30% of post-menopausal women suffering from this multi-factorial progressive skeletal disorder described as a silent killer (Hassanine et al., 2017). The symptoms include: a decrease in bone mass, reduced bone strength, deterioration of bone tissue and compromised bone architecture (Rubin, 2005). Consequently, increasing the risk of fragility and fractures, which may cause a reduced quality of life, morbidity and mortality (Bolland et al., 2010). However, strength training not only delays the onset of osteoporosis (Gupta and March, 2016) but is also the most effective non-pharmaceutical treatment (Lirani-Galvão and Lazaretti-Castro, 2010). The mechanisms underlying this include promotion of bone osteogenesis (Turner and Robling, 2006), promotion of the bone-piezo electric effect (stimulation of bone cellular activity and mineral deposition) (Menkes et al., 1993), stimulation of bone formation and inhibition of bone reabsorption (Andreoli et al., 2001). These mechanisms lead to an increase in bone strength and bone density, reducing the risk of osteoporosis and consequent fractures to preserve quality of life whilst most importantly reducing the risk of morbidity and mortality (Lirani-Galvão and Lazaretti-Castro, 2010).
2.) Increased Cardiovascular Health
Cardiovascular disease is the leading cause of death in elderly women. The average lifetime risk of developing cardiovascular disease for a 50-year-old woman stands at an astonishing 40% (Garcia et al., 2016). Strength training improves cardiovascular health by reducing the risk of heart disease, improving cholesterol levels and lowering blood pressure (Westcott, 2012), whilst also displaying positive effects on the risk factors for cancer and diabetes. A study by Shiroma et al. (2017) reported women engaging in strength training were 30% less likely to suffer from type 2 diabetes and 17% less likely to develop a cardiovascular disease. The underlying mechanisms for this are highlighted in a systematic review by Zang et al. (2014) which includes: increased muscle mass, reduced BMI, enhanced insulin sensitivity, increased glucose transportation and improved glycemic control. A study by Gerage et al. (2013) reported that after 12-weeks of strength training (2x per week) postmenopausal women displayed a significant reduction of 5mmGh in systolic blood pressure, with no significant effects on diastolic blood pressure or heart rate variability. Consequently, strength training at least twice a week can significantly reduce the risk of women developing cardiovascular disease and increase their chances of living a longer and healthier life.
3.) Better Posture
Kyphosis (an excessive curvature in the thoracic spine) increases by 6-11% per decade in women over 55-years old (Katzman et al., 2007). Age-related postural defects such as hyperkyphosis may impair pulmonary function, reduce quality of life and predict mortality rate (Bansal, Katzman and Giangregorio, 2014). After the age of 40, women start experiencing an array of changes which may lead to an increased risk of postural defects, these include: a decreased efficiency of central and peripheral neurones, weight loss and reduced protein synthesis rates, which in turn can lead to a decrease in both skeletal and muscle mass (Drzal-Grabiec et al., 2013). A combination of this increased fragility of connective tissue and reduced muscle strength causes negative effects on posture (Katzman et al., 2010), leading to subconscious compensatory patterns which may cause greater impairment of the spinal curvature and consequent issues for the shoulders, hips and knees. A study by Katzman et al. (2007) reported that older women who undertook strength training twice a week for a 12-week period saw their posture improve by 11% with their spinal extensor strength increasing by 21%. These improvements in posture are achieved through strengthening of the posterior chain and muscles supporting your spine, correcting structural asymmetries and eliminating muscle imbalances. Resulting in a reduction of aches, pain, injuries and the risk of falling; leading to a more comfortable and enjoyable lifestyle.
4.) Reduced Injury and Risk of Falling
Approximately one-third of the population over the age of 65 falls at least once a year, with the probability of falls for women over the age of 65 being 31.9% (Zhao et al., 2020). Falls may lead to fractures, disabilities, psychological disturbances and even death; with falls being the second leading cause of fatal injury worldwide (Afrin et al., 2016). A major cause for the increased incidences of falls observed in the elderly is a reduction in postural control (Alfieri et al., 2012). A study by Choy, Brauer & Nitz. (2003) suggests a reduction in postural stability is noticeable for women as early as their 40s and continues to significantly decrease during each subsequent decade. A meta-analysis by Claudine et al. (2021) reported that strength training significantly reduces the risk of falling in the elderly. Moreover, combining strength training with multi-sensory exercises improves balance and stability to further reduce the risk of falling. The mechanisms underlying this are reducing oscillation of the bodies centre of pressure, whilst also improving action in the gastrocnemius and tibialis anterior; the first muscles called into action when attempting to maintain balance before falling (Alfieri et al., 2010). Consequently, strength training can help to reduce the risk of falls and the injuries associated with this including fractures, breaks and even death.
5.) Increased Muscle Mass and Weight Management
Sarcopenia is defined as an involuntary loss of muscle mass attributed to ageing (Walston, 2012). A study by Flack et al. (2011) reported that adults lose 3-8% of their muscle mass every decade after the age of 30, leading to a decrease in metabolism and strength, as well as an increase in weight and body fat percentage (Ryan, 2000).This can be partly attributed to the high variability of hormone levels during the premenopausal state, such as an increase in follicle stimulating hormone and a decrease in estradiol, which causes women to lose between 42-63% more muscle mass than men (Delshad et al., 2023). Sarcopenia causes a significant increase in the risk of frailty, fractures, falls, disabilities and most concerning of all premature morbidity and mortality (CJ and Cuevas, 2012). However, strength training is cited as not only the most effective preventative measure to delay the onset of sarcopenia, but also the most effective treatment to combat its negative consequences (CJ and Cuevas, 2012); this is achieved through increasing lean muscle mass, aiding weight management and increasing strength (Mayer et al., 2011). A study by Orsatti et al. (2008) reported that after 16 weeks of training (3x a week) that postmenopausal women saw a significant increase of 1.8kg of muscle mass, a 2.1% increase in BMI and a 37.8% increase in insulin-like growth factor 1 (a hormone vital for promoting bone and tissue growth). This was further supported by Botero et al. (2013) who reported that after 12 months of strength training postmenopausal women saw significant increases in strength, represented by improvements in their 1-rep max (1RM = how heavy you can lift a certain amount of weight for 1 rep); with a 31% increase in bench press, a 101% increase in leg press and a 26% increase in arm curl. Furthermore, they also reported beneficial body composition results with; a 1.5% decrease in weight, 2.6% decrease in body fat percentage and a 1.6% increase in lean muscle mass. Therefore, strength training is the most effective way for delaying the onset of sarcopenia, as well as combating its symptoms and the aforementioned consequences associated with it.
6.) Improved Self-esteem
Self-esteem is a vital component of well-being with lower levels of self-esteem being associated with a multitude of negative consequences including anxiety, dissatisfaction, self-loath and depression (Dąbrowska-Galas and Dąbrowska, 2021). Moreover, lower self-esteem is associated with an increased risk of negative menopausal outcomes in women, leading to an unhappy and stressful experience during this significant time (Quiroga et al., 2017). However, physical activity has been suggested to combat these negative symptoms of menopause and enhance self-esteem (Dąbrowska-Galas and Dąbrowska, 2021). Strength training has a range of mental health benefits, reducing symptoms in adults suffering from pain, fatigue, anxiety and depression, as well as improving cognitive ability (Westcott, 2012). A study by Sing, Clements and Fiatarone (1997) reported that over 80% of the depressed elderly participants who trained 3x a week over a 10-week period were no longer clinically depressed upon completion of the programme. Moreover, a review by O’Connor, Herring and Carvalho (2010) highlighted 6 separate random controlled trials which displayed the benefits of strength training on improved self-esteem. Strength training empowers women by making them feel stronger and more confident, whilst also offering an abundance of other significant benefits for their mental health.
7.) Better Sleep
A common problem associated with ageing is a decrease in quality of sleep, which is usually portrayed by a reduction in REM sleep and replaced with a lighter and more fragmented version (Cooke and Ancoli-Israel, 2011). This may lead to negative effects on the coronary artery, blood pressure and sympathetic tone, whilst also being associated with depression, arthritis, obesity, stroke and lung disease (Foley et al., 2004). A study by Ferris et al. (2005) reported that after 6 months of training elderly participants experienced a 19% increase in strength accompanied by a 38% increase in sleep quality. Furthermore, a study by Ferris et al. (2005) found that after 8 weeks of combined strength and aerobic training, the sleep quality of elderly women significantly improved from ‘poor’ to ‘good’ when assed using The Pittsburgh Sleep Quality Index. The improvement in quality of sleep resulting from strength training not only promotes a generally happier sense of wellbeing but also has many significant benefits on health.
Recommendations
A study by Rodríguez et al. (2018). Reported that when compared to aerobic exercise and aqua fitness; strength training produced the greatest improvements across a wide range of variables including but not limited to; strength, flexibility, weight loss, BMI, pain reduction, general health and quality of life. Therefore, at The Health and Fitness Lab we recommend that women over the age of 40 should incorporate at least 2 60 minute strength training sessions into their weekly routine. However, it is important to acknowledge the dangers of strength training particularly in untrained elderly individuals, therefore we advise that any strength training should be prescribed and supervised by a registered exercise professional.
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