StrengthSpan - what the hell is that?

It is well established that as we age, we lose muscle strength. What is also becoming frequently recognised is the need for strength training to be part of the older populations regular exercise routine. Strength is well correlated with longevity, reduced risk of non-communicable diseases and improved quality of life in the older population (1) It makes sense. If you are stronger you are able to move more, lift more and will ahve better balance. Couple with that, the more recent research that reveals positive benefits to the brain, memory and cognition. Strength training and maintaining your strength is a vital part of growing older better!

FOCUS

The commentary article was recently published in the British Journal of Sports Medicine (2) and proposed the concept of Strengthspan. The authors highlight the current focus on the elderly and strength training may be looking at it from the wrong angle. Instead, focus on the entire span of a hum,an being an d aim to maximise strength throughout. Focus on building a strong foundation of strength and lean mass in the formative years. In doing so, also improve bone mineral density, motor patterns and cognition.

"If we are to foster health ageing, we must recognise the importance of extending the strengthspan from the geriatric years back to a foundation of muscular strength and physical function in the paediatric years." Faigenbaum et al, 2024.(2)

Whilst the mention of 1RM activities as a means of tracking is not necessarily embraced by myself, some sort of system of tracking or objective baselining and progressive assessment would make sense. This would need to be age appropriate as well as applicable to what is to be achieved. Simple measures such as grip strength, hanging bar holds, max push ups could be applied early in life and then progressed to simple strength tests such as leg press, bench press and chin ups. Standardisation and follow up over decades of years would make for fascinating reading. To neglect aerobic fitness would be a mistake as longevity is also correlated to VO2max (3). Simple staged distance tests appropriate for age cohorts could be applied and gradually include metabolic cart testing in later life to ensure accuracy and completeness.

CHILDHOOD

The authors outline their proposed three stages of life to focus on. beginning at childhood. What is interesting and unknown to me was the following association and correlation.

"Weaker youth, lacking confidence and competence in their physical abilities, tend to become weaker adults who lack the desired skills and behaviours that support ongoing participation in muscle strength activities as they age." Faigenbaum et al, 2024.(2)

I think what needs to be remembered here is the gym classes that did not take into account the varying levels of athletic ability of the children in them when we went through school. For some children, it was a joy and breeze, for other dread and hate. Having systems in place and ways to identify those children who require more guidance and assistance is the way to improve outcomes. Not focusing on the gifted and leaving the weakest behind. Remember, a pack or team is only as strong as it's weakest member.

ADULTHOOD

It is painfully apparent that the worlds population of adults is struggling with health and fitness. According to the WHO, 16% of adults aged 18 years and older worldwide were obese in 2022. That number will have increased since then. This is obese, not overweight and at risk of disease. As such, something has to change. What is known is the regular participation in muscle strength activities (MSA) can reduce the risk of disease. In fact, the risk of disease is reduced even if the individual only participates in strength exercise independent of aerobic exercise. The aerobic exercise component amplifies the effect yet is not a requirement to improve your healthspan and lifespan.

"Improvements in muscular strength and function during adulthood can attenuate the decline in biological processes (mitochondrial dysfunction and cellular senescence) that contribute to serious disease or disability." Faigenbaum et al, 2024.(2)

Social media and influencers are regularly talking about biohacks to increase longevity. The best hack of all is lifting heavy objects to increase your strength and thus your strengthspan. Couple this with effective nutrition to amplify the adaptation and the correct mount of recovery in the form of 7-9 hours of sleep on a daily basis and you have your recipe for living a better and longer life. Simple yet hard work required. Dammit :)

OLD AGE

The worlds population has aged. As a result, a focus on the elderly has arisen. The relationship between reduced physical strength and reduced outcomes in life are established. Sarcopenia is the progressive loss of muscle as we age. By old age, that loss may be too late to recover as it is harder to gain lean mass in later life than early on. As such, the focu s at the pointy end of life, whilst commendable, is wrong. It needs to begin well before old age sets in. THe authors lay this out well wth the quote below.

"Inadequate muscular strength activities can worsen sarcopenia, diminish functional autonomy and increase the risk of developing chronic health conditions." Faigenbaum et al, 2024.(2)

If you are elderly, then certainly engage in strength training. If your parents or siblings are elderly, then please encourage them to engage if they are not already. It really is that important.

HOW DOES THIS RELATE TO ENDURANCE ATHLETES?

Occasionally, I hear push back from athletes who say they do not want to lift weights because they get bulky andit interferes with their performance. Most of the time I call "Bullsh&t" and say that they just don't like being sore initially and it can interfere with the short term training. Log term it will benefit the training. Of course, correct periodisation of intensity and load are required YET some strength training should be incorporated all year round. Periods of more volume will happen at set points based on the season.

However, more importantly to think about is the long term picture. You will not be a endurance athlete forever and you do not want to sacrifice your later years in order to be a "little lighter" on the bike or run. Think about why you started endurance sports in the first place. Likely, it was to be healthy. Do not let the sport you chose be the reason for your demise in later life. it does not have to be. It is like the argument against taking creatine monohydrate due to some small weight gains. The benefits related to strength far outweigh that argument.

CONCLUSION

Personally, I love this concept of strengthspan and how it relates to longevity, healthspan and thus lifespan. It is not about living longer. It is about living better. Gaining strength and then maintaining through life can improve physical capacity, confidence, co-ordination, reduce injury prevalence, improve cognition and reduce disease risk. Focusing on our youth and having a continuum makes sense to me. The buy in has to come from parents, teachers, schools and governments to turn the tide on the sarcopnic obesity crisis we are currently in.

REFERENCES

1. Momma, Haruki et al. “Muscle-strengthening activities are associated with lower risk and mortality in major non-communicable diseases: a systematic review and meta-analysis of cohort studies.” British journal of sports medicine vol. 56,13 (2022): 755-763

2. Faigenbaum, Avery D et al. “Bridging the gap between strengthspan and lifespan.” British journal of sports medicine vol. 58,14 758-760. 1 Jul. 2024, doi:10.1136/bjsports-2024-108357

3. Clausen, Johan S R et al. “Midlife Cardiorespiratory Fitness and the Long-Term Risk of Mortality: 46 Years of Follow-Up.” Journal of the American College of Cardiology vol. 72,9 (2018): 987-995. doi:10.1016/j.jacc.2018.06.04