Continuing my summary of Jonathan Sullivan's "The Year in Strength Science, 2013" with Part III on Big Medicine. (full text)
(1) Sully presents a meta-analysis done by some Canadians which finds shockingly few good randomly-controlled trial studies on hypertension and resistance training. The conclusion can only be that there is "insufficient evidence" to support the prescription of strength training for high blood pressure. Sully rants, "A single, large, properly powered, long-term RCT using high-dose resistance training would answer this question. Why the hell doesn’t somebody just do it?"
(2) "2013 saw more papers on the role of exercise medicine in the treatment or prevention of insulin resistance, metabolic syndrome and diabetes. ... I’ll just point out two representative papers for interested readers. The first is an original investigation by Croymans et al [35], who observed an increase in insulin sensitivity in resistance-trained obese young men. The second is a non-systematic review of the evidence by Mann et al [36]. Their survey of the literature found that the preponderance of the evidence shows any form of exercise improves metabolic control and insulin sensitivity, but that a combination of resistance training and conditioning seems to have the most powerful effect." (p. 18)
(3) In a small study of strength training's effect on muscular dystrophy patients: "Indeed, boys treated with exercise therapy demonstrated stabilization of the Motor Function Movement assay, whereas boys in the control group manifested minor declines, consistent with the progressive nature of this horrific disease." However, Sully cautions the need for bigger, better designed, and more rigorous studies before "doctors can make informed recommendations about resistance training in this population." (p. 19)
(4) "In a study that is bound to get some attention, Keating et al [43] found an association between strength training and self-reported academic performance in University students. This would be something to crow about if the data weren’t so limited and if we knew the causal direction, if any, of this association. Were these students smarter because they trained? Did they train because they’re smarter? Or was there no relationship, other than a statistical one, between the two variables? We don’t know. This is a hypothesis generator, nothing more." (p. 19)
(5) "Murlasita and Mohammad [48] present a nice overview of a problem that should be on the minds of all serious strength coaches and older athletes: the potential for adverse interaction between statin medications and training." There's evidence that "statin-induced myopathy is more prevalent than previously thought, that it is more common in the aged and
individuals engaged in strenuous exercise, and that it can on occasion lead to serious consequences, including full-blown rhabdomyolysis, acute tubular necrosis and renal failure." (p. 21)
There's also a bunch of stuff I don't really understand on the possible effects of lifting on congestive heart failure (p. 17), where there's also this great aside: "Perhaps more importantly, it underscores an important emerging concept I alluded to earlier: the idea that muscle tissue is an endocrine organ. It is, in fact, a gland, an organ that participates in physiological regulation by releasing signaling molecules with profound tissue-level and systemic effects. And like any gland, it can get sick. Sick, weak, atrophic muscle is like a sick, weak, atrophic thyroid, pituitary or adrenal. The consequences are potentially devastatin."
(1) Sully presents a meta-analysis done by some Canadians which finds shockingly few good randomly-controlled trial studies on hypertension and resistance training. The conclusion can only be that there is "insufficient evidence" to support the prescription of strength training for high blood pressure. Sully rants, "A single, large, properly powered, long-term RCT using high-dose resistance training would answer this question. Why the hell doesn’t somebody just do it?"
(2) "2013 saw more papers on the role of exercise medicine in the treatment or prevention of insulin resistance, metabolic syndrome and diabetes. ... I’ll just point out two representative papers for interested readers. The first is an original investigation by Croymans et al [35], who observed an increase in insulin sensitivity in resistance-trained obese young men. The second is a non-systematic review of the evidence by Mann et al [36]. Their survey of the literature found that the preponderance of the evidence shows any form of exercise improves metabolic control and insulin sensitivity, but that a combination of resistance training and conditioning seems to have the most powerful effect." (p. 18)
(3) In a small study of strength training's effect on muscular dystrophy patients: "Indeed, boys treated with exercise therapy demonstrated stabilization of the Motor Function Movement assay, whereas boys in the control group manifested minor declines, consistent with the progressive nature of this horrific disease." However, Sully cautions the need for bigger, better designed, and more rigorous studies before "doctors can make informed recommendations about resistance training in this population." (p. 19)
(4) "In a study that is bound to get some attention, Keating et al [43] found an association between strength training and self-reported academic performance in University students. This would be something to crow about if the data weren’t so limited and if we knew the causal direction, if any, of this association. Were these students smarter because they trained? Did they train because they’re smarter? Or was there no relationship, other than a statistical one, between the two variables? We don’t know. This is a hypothesis generator, nothing more." (p. 19)
(5) "Murlasita and Mohammad [48] present a nice overview of a problem that should be on the minds of all serious strength coaches and older athletes: the potential for adverse interaction between statin medications and training." There's evidence that "statin-induced myopathy is more prevalent than previously thought, that it is more common in the aged and
individuals engaged in strenuous exercise, and that it can on occasion lead to serious consequences, including full-blown rhabdomyolysis, acute tubular necrosis and renal failure." (p. 21)
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