By: Jean Johnson for Heart1You don’t have to be a marathon runner to count in the judgment of Kathryn H. Schmitz, PhD, assistant professor at the Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania. In fact, you don’t even have to be keeping your weight under control.
As the Centers for Disease Control and Prevention estimated, 65 percent of adults in the United States are overweight or obese. So Schmitz did the sensible thing; she paid attention to the idea that so many were struggling with extra weight and designed her study around 164 women between the ages of 25 and 44 who fall into the overweight and obese categories.
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Before starting a strength training program:
Consult with your physician.
Consider a personal trainer.
Make sure you have good foot gear and loose, comfortable clothing.
Think about a schedule that is realistic for you to maintain consistently.
Remember that a heart healthy plan is all about you and not a competitive endeavor. Start with weights that will not strain your joints and muscles and progress slowly.
Lastly, strategize ways to make your workout as enjoyable as possible. Load some of your favorite music onto an iPod or Walkman. Try exercising first thing in the morning when you are energized. Or even shop around for a trainer who’s easy on the eyes – whatever it takes! |
“This is so encouraging,” said Jan Doucette of Chicago, who knows she is heavier than she should be. “I’ve tried so hard to deal with my weight, and I know that as I’m getting older I’m going to start paying the price. And all this heart talk really scares me. So to have someone actually looking at the problem instead of just telling all us fatties to go on a diet really means a lot. It’s like you have to start where people are.” Two Days a Week is Good Enough
Schmitz found that even if women are overweight or obese and not trying to lose, their intra-abdominal fat – the particularly bad kind of belly fat that wraps around the internal organs and is closely associated with heart disease as well as diabetes – will decrease with a 30-minute strength-training program two days a week.
Two days a week only. That is Schmitz’s second point of emphasis. If an exercise program is going to work, it must be manageable. She spoke about the concept of “tolerable dose” to the University of Pennsylvania’s newspaper, the Penn Current, using an analogy of how drug companies craft the medications they market.
“When they test the efficacy of a drug, one of the things that’s important is if it’s tolerable at the recommended course of treatment,” Schmitz said. “Is it something patients will do?”
For example, manufactures had to figure out that antidepressants had to be formulated in user-friendly doses. As Schmitz observed, “There was a time when antidepressants had to be taken multiple times a day. If you’re going to market something, it has to be behaviorally feasible. We demand this of our drugs. If a drug is much better but you have to take it three times a day, it won’t sell as much.
“We’re not saying that you shouldn’t be doing aerobic exercise,” she told the Penn Current. “In fact, studies have shown that aerobic exercise reduces intra-abdominal fat. But from the public health perspective, I’m interested in what’s really feasible, and I know for myself, with two children and being an academic, going to the gym twice a week is something I can handle.”
“I like it,” said Doucette, “because you know that women who are heavy probably aren’t used to exercising that much in the first place. Also doing those heart rate workouts is really hard on larger ladies. I mean, I start sweating just by walking into a gym. I don’t need to get on the treadmill to do that! So just going in and lifting some weights a couple of times of week seems like a place to start that’s not too intimidating or too ambitious.”
SHE = Strong, Healthy, and Empowered
Schmitz’s study was dubbed SHE for Strong, Healthy, and Empowered. And for her innovative, inclusive approach to heart research, she was awarded the Trudy Bush Fellowship for Cardiovascular Research in Women’s Health from the American Heart Association’s Council on Epidemiology and Prevention in March of 2006.
She chose participants for her study from Minnesota. Approximately 40 percent of the sample was non-Caucasian, about two-thirds were college educated, and about half had children at home. All had similar caloric intake and they were asked not to change their eating habits for the duration of the study.
According to the Penn Current, “One group was given a two-year membership at the YMCA and four months of supervised strength training classes. After the initial training period, the women were instructed to continue twice weekly sessions on their own, with booster classes four times a year. Women in the other group were given brochures recommending 30 minutes to an hour of exercise most days of the week.”
The outcome was as expected. Those with the heavy exercise schedule and no support tended to get discouraged and quit, while those with more moderate, supported goals hung in there. At the end of the two-year study, the group that did the two-day per week strength training had an increase of only 7 percent intra-abdominal fat, while the other group was up 21 percent. “I was surprised by the magnitude of the results,” Schmitz told the Penn Current.
Accepting Reality about Middle Age Can Help Keep Expectations Reasonable
“On the average, women in the middle years of their lives gain one to two pounds a year and most of this is assumed to be fat,” Schmitz said in an AHA briefing. “This study shows that strength training can prevent increases in body fat and attenuate increases in the fat deposit most closely associated with heart disease. While an annual weight gain of one to two pounds doesn’t sound like much, over 10 to 20 years the gain is significant.”
That said, Schmitz concedes that her approach is a “tough sell.”
“I can just see the infomercial,” she told the Penn Current. “Follow this program and you can stay exactly where you are! Most people when you talk about weight control, want the end result to be that they look like Halle Berry or Heather Locklear.”
But referring to the one to two pounds middle aged women normally tend to gain each year she pointed out: “That’s a significant weight gain and a significant risk.” Consequently what Schmitz hopes to do is help women modify their expectations to fit the reality that advancing age brings. “My goal at this point,” she noted, “is to weigh at 50 what I weighed at 40.”
Doucette said that this too resonates. “I confess that I’ve always had an on-again off-again attitude toward dieting and exercise. Either I wanted to be perfectly thin and practically starved myself and did all this walking, or I just gave up and dove into the chips on the couch. So the idea of not changing my diet and just doing a little exercise is different and something that sort of catches my attention.
“It’s like she’s saying, ‘well let’s not skin this cat all at once or maybe ever. Instead let’s just see if we can’t improve things a little without rocking the boat too much,’” said Doucette. “And you know, I think that’s what I’ve needed to hear for years now. I’m going to join the gym next week and get a personal trainer for few sessions. And I’m going to promise myself to keep the bubble in the middle and do only two days a week for 30 minutes – and no more.
“Also, I like her idea about keeping your weight goals realistic and just aiming to not gain any more pounds. I hadn’t realized that all women automatically thicken as they age, but now that I know, I’m going to try and tell myself that just not gaining would be a victory. I know there’s a place in my head that says that’s not good enough, but I’m going to try and convince her that just for now, maybe it is.”
If Schmitz could hear Doucette’s comments she might be pleased. The assistant professor confided to the AHA that, “Making women stronger and more confident behaviorally may serve as a gateway to getting overweight women to be more active.”
We at Heart1 hope so. But at the very least, it seems that just getting to the gym twice a week is a great start.
