New findings widen the cardiovascular value of muscular workouts 10/11/2018
The ancient Greek physician Hippocrates famously said, “let food be your medicine”.
While that’s still very true, ancient Greeks were far more active than most modern Americans.
Today, Hippocrates would be wise to update his advice to “let food and exercise be your medicines.”
People at risk of — or with — heart problems are typically advised to exercise, with the emphasis on aerobic workouts like running, swimming, and bicycling.
But recent findings make strength training look like an equal priority when it comes to preventing or diminishing cardiovascular disease.
Before we dive into the remarkable results of a new evidence review, let’s scan some background to the new analysis from Basque country.
The muscle-heart connection: An overlooked opportunity
The new evidence review comes from researchers based in Spain’s northwest Basque region (Carmen Fiuza-Luces et al. 2018).
Setting the stage for their study, they lamented that “... the huge potential of resistance exercise and strength training to ... improve cardiovascular health gets scant recognition in the majority of clinical treatments.”
That oversight prompted them to take what they called “a comprehensive view of cardiovascular diseases in the context of the human body as a whole”, with a focus on the effects of strength training.
And they noted that the cardiovascular system (heart, blood vessels, and blood) “… should not be separated from the other organs, such as the skeletal muscles or intestinal microbiota [gut microbes], when addressing cardiovascular diseases.”
As they wrote, a summary of the evidence concerning strength training’s effects on cardiovascular health “… could be of great help for health professionals who prescribe no physical exercise for their patients.”
We’d add that their summary should serve to educate doctors who prescribe exercise but aren’t aware of the specific cardio benefits of strength training.
Accordingly, their review encompassed the available evidence concerning “… the interaction between the heart and blood vessels with other tissue, including skeletal muscle, adipose tissue and even the intestines …”.
Evidence review sees unique cardio benefits from strength training
The new evidence review was led by Mikel Izquierdo, who said their study was prompted in part by a little-known aspect of heart health: “The loss of muscle strength and mass is one of the 'forgotten' risk factors in cardiovascular disease.”
Fortunately, that’s something most folks can do something about, because loss of muscle strength can be corrected quickly with a strength training program — regardless of your age.
The purpose of the Basque team’s review was to find and gather evidence on how muscle-focused workouts influence the cardiovascular and immune systems.
Dr. Izquierdo and his team examined 154 previous studies concerning the effects of aerobic and strength exercise on cardiovascular health and the results appeared in the journal Nature Reviews Cardiology.
After analyzing the studies, the Basque scientific team concluded that regular exercise designed to boost muscle strength brings unique cardiovascular benefits.
The Basque team said they believe strength training should be considered “a medicine for treating cardiovascular diseases.”
And as they wrote, “… unlike most drugs, exercise is largely free of adverse effects, and its benefits are to a certain extent dose-dependent.” (In other words, people can gain growing cardiovascular benefits as they make their muscle workouts more challenging.)
Their review showed that strength training enhances cardiovascular health through “non-traditional” means — especially via two novel mechanisms:
- Beneficial changes to gut microbes (intestinal microbiota).
- Release of anti-inflammatory messenger proteins (myokines) from skeletal muscle
Let’s examine both of those benefits in a bit more detail, because the specifics bolster the case and may prove motivating.
Exercise helps cardiovascular health via the gut
It turns out that certain gut microbiome “phenotypes” promote cardiovascular disease.
Gut phenotypes vary among people and are defined by their varying blends and proportions of microbes.
An unhealthy gut microbiome phenotype can raise the risk of CVD in at least five ways:
- Increase body fat
- Raise blood pressure
- Raise production of relatively toxic microbial metabolites
- Raise rates of infiltration of arterial plaques by unhelpful microbes
- Yield higher and lower blood levels of triglycerides and HDL, respectively.
The good news is that, as the Basque researchers wrote, “regular exercise, by contrast, modulates the gut microbiota towards a healthy phenotype.”
Better yet, intense exercise appears to reduce the permeability of your intestinal lining/barrier — which helps keep pro-inflammatory, plaque-promoting bacterial toxins out of your bloodstream.
If you want to learn more, we wrote about related research earlier this year, in Is Exercise the New Yogurt?.
Strength workouts generate — but mostly dampen — inflammation
The apparent anti-inflammatory effects of muscle workouts seem counterintuitive.
They're surprising because resistance training and aerobic activities like running generate inflammation in the affected muscles.
But skeletal muscle is also an “endocrine” organ that — when stressed by exercise — releases anti-inflammatory messenger proteins called myokines.
Those myokine proteins dampen local and system-wide inflammation — including the arterial inflammation that drives cardiovascular disease — and reduce diabetes-promoting insulin resistance.
In fact, myokines appear to protect arteries against the buildup of arterial plaque and stabilize existing plaques, thereby helping to keep them from shedding dangerous, artery-clogging chunks.
The benefits of body-based workouts
Strength training comes in two broad categories:
- Body-based workouts
- Workouts with weights, machines, and other tools.
It’s wise to gain expert guidance and only extend your effort to a safe and healthy extent: advice that applies particularly to exercising with weights and other resistance-training tools.
You can pick from of any of several quick, body-based workout plans designed for home or (to some extent) office.
These routines combine the (underappreciated) cardiovascular benefits of resistance training with those of aerobic exercise, which more directly challenges your lungs and heart.
Last year, we reported on one of the most efficient, well-studied routines in 7-Minute Fitness HIIT, under the heading “Johnson & Johnson’s 7-Minute Workout”.
That article also provided a link to a New York Times article with HIIT exercise illustrations and links to a free downloadable NYT mobile HIIT app.
- Beavers KM, Ambrosius WT, Rejeski WJ, Burdette JH, Walkup MP, Sheedy JL, Nesbit BA, Gaukstern JE, Nicklas BJ, Marsh AP. Effect of Exercise Type During Intentional Weight Loss on Body Composition in Older Adults with Obesity. Obesity (Silver Spring). 20
- Carmen Fiuza-Luces, Alejandro Santos-Lozano, Michael Joyner, Pedro Carrera-Bastos, Oscar Picazo, José L. Zugaza, Mikel Izquierdo, Luis M. Ruilope & Alejandro Lucia. Exercise benefits in cardiovascular disease: beyond attenuation of traditional risk factors. Nature Reviews Cardiology (2018)
- Cerdá B, Pérez M, Pérez-Santiago JD, Tornero-Aguilera JF, González-Soltero R, Larrosa M. Gut Microbiota Modification: Another Piece in the Puzzle of the Benefits of Physical Exercise in Health? Front Physiol. 2016 Feb 18;7:51. doi: 10.3389/fphys.2016.00051. eCollection 2016. Review.
- Di Raimondo D, Miceli G, Musiari G, Tuttolomondo A, Pinto A. New insights about the putative role of myokines in the context of cardiac rehabilitation and secondary cardiovascular prevention. Ann Transl Med. 2017 Aug;5(15):300. doi: 10.21037/atm.2017.07.30. Review.
- Pedersen BK. Exercise-induced myokines and their role in chronic diseases. Brain Behav Immun. 2011 Jul;25(5):811-6. doi: 10.1016/j.bbi.2011.02.010. Epub 2011 Feb 25. Review.