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The association between resistance exercise and cardiovascular disease risk in women

Objectives: The objective of this study was to examine the association between resistance exercise and cardiovascular disease (CVD) risk, independent of body composition, physical activity and aerobic capacity, in healthy women.

Design: A cross–sectional analysis including 7321 women with no history of heart disease, hypertension or diabetes was performed.

Methods: Participation in resistance exercise was self–reported and body weight and height was measured. A single CVD risk score was established via factor analysis including percent body fat, mean arterial pressure, fasting glucose, total cholesterol and triglyceride levels. Physical activity level was determined based on questionnaire data and aerobic capacity was assessed via a maximal treadmill exercise test.

Results: Women reporting resistance exercise had lower total CVD risk at any age. Specifically, resistance exercise was associated with lower body fat, fasting glucose and total cholesterol. The association between resistance exercise and CVD risk, however, remained only in normal weight women after adjusting for physical activity and aerobic capacity.

Conclusion: Results of the present study underline the importance of resistance exercise as part of a healthy and active lifestyle in women across all ages. Our results suggest that resistance exercise may be particularly beneficial to independently improve CVD risk profiles in women with normal weight. In overweight/obese women, total physical activity and aerobic capacity may have a stronger association with CVD risk.


Alex’s Notes: Here we have an analysis of 7,321 women aged 20-90 years (average 45.5-years) with no history of heart disease, hypertension, or diabetes. Why does this matter? Because with less than 20% of the U.S. women population engaging in regular resistance training (RE), it must be emphasized what benefits (if any) strength training has on cardiovascular disease (CVD) risk and risk factors. The women self-reported their participation in RE as frequency (times per week) and duration (minutes per session). Just over 30% had their body-fat estimated via hydrostatic weighing, while the remainder used 7-site skinfold measurements. Blood work was taken fasted.

First off & surprisingly, no differences in CVD risk were seen in women who reported less than 60 min/week compared to those who reported more than 60 min/week, but a difference was present when either group was compared to those who did not resistance train. Thus, simply doing the minimalist work will see benefit. I would honestly be surprised if a woman could not dedicate 60 minutes (or less!) per week to resistance training. That said, the groups were combined for subsequent analyses, forming the RE group and the no-RE group. Additionally, women were sub-divided into normal and overweight/obese with a BMI cut-off of 25 kg/m2, and stratified by age at 45- & 55-years.

Compared to the national average, these women did pretty good with 37% reported regular RE. However, this is likely explained by the inclusion criteria that allowed for things like calisthenics in addition to strength training. The prevalence of overweight/obesity was greater in those not performing RE (34.5%) compared to those who did (20%), and total physical activity and cardiorespiratory fitness was greater in the RE group as well, even after adjustment for BMI and age. On average, body fat percentage, triglycerides, fasting glucose, and total cholesterol were also lower in the RE group.

The relationship between RE and fasting glucose was lost when the women were stratified by age, but remained in all age groups for total cholesterol and percent body-fat. Triglycerides only remained significantly lower in women over 56-years of age. When stratified by body normal weight vs. overweight, fasting glucose was only significantly lower in the normal weight group, while total cholesterol and percent body fat were lower in both for RE.

Bottom line: Women, go lift something heavy.

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