It’s an unfortunate fact of life: as we age, things just don’t work quite as well as they used to. Our bodies might slow down and we might develop medical conditions that can threaten our livelihood, considering our risk for developing chronic diseases, such as cardiovascular disease, type 2 diabetes, cancer and mobility disability, increases with age.

Fortunately, though, it’s well established that we can do something to fight this decline. Regular physical activity can decrease the risks of developing chronic disease. There are many guidelines available to help guide older adults to participation in the right types and amounts of exercise to decrease the risk of developing disease.

Most of these guidelines, which are from organizations such as the American College of Sports Medicine and American Heart Association, emphasize the performance of aerobic activity, with recommendations for 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic exercise per week. These guidelines often include recommendations on resistance, balance, and flexibility training, but the emphasis is usually on aerobic exercise. However, is this emphasis on aerobic exercise right? Or should there be a more balanced emphasis including other forms of exercise?

A recent study review, published in the journal Frontiers in Physiology in 2019, examined this very topic, specifically regarding disease risk with resistance exercise versus aerobic exercise. Resistance exercise and aerobic exercise are often seen as being at two ends of the exercise spectrum, with each offering distinct health benefits. Many people view resistance exercise, which is using your body weight or external weight to improve muscular strength and endurance, as what you perform if you want to build muscle. Aerobic exercise (running, walking, biking, etc) on the other hand, is often viewed as what you perform when you want to improve your cardiovascular and overall health. This review, however, found that resistance exercise may be as effective as aerobic exercise at reducing the risk of many chronic diseases, and could even be more effective in some regards.

The review looked at some of the most prominent chronic diseases including mobility disability (impairments in how we get around), type 2 diabetes, cardiovascular disease and cancer.

For physical mobility, there are multiple systematic reviews (strong study design) demonstrating that programs which combine resistance exercise and aerobic exercise are superior to those that include only resistance or aerobic exercise alone. However, many studies examining this topic have the combined-training groups perform more overall exercise than the aerobic-only or resistance-training-only groups. When trying to determine if aerobic or resistance exercise should be emphasized in a program, this isn’t particularly helpful. In addition, most people don’t want to perform more exercise if they don’t have to.

Low muscle mass and strength, though, is associated with poor physical function and future impairment of mobility in older adults. Resistance training provides a strong stimulus for building strength, and a 2011 systematic review published in the journal Medicine & Science in Sports & Exercise found that resistance training alone built strength in frail older adults better than combined-exercise programs that didn’t include resistance training, such as a combined aerobic and balance training program. In addition, a 2018 study published in the Journal of Sports Medicine found that aerobic exercise alone is nowhere near as effective at increasing muscle strength compared to resistance training.

If you’ve been reading my column for some time, you may recall a column where I covered a study that showed performing heavier resistance exercise resulted in improved muscle strength versus lighter resistance exercise and was safe for older adults when performed correctly. The 2019 review echoed this idea in that heavier training is generally more effective than lighter training. However, the review noted that improvements in physical function can be seen with using only one’s body weight for resistance when functional activities are simulated, such as with a body weight squat or repeatedly standing up and sitting down to a chair.

The benefit of resistance exercise on physical function and mobility is not surprising due to the strength needed for activities such as climbing stairs or standing up from a chair. Maintaining physical function can also be vital to sustaining regular movement and activity to decrease the risk of developing other chronic diseases.

Check back at my next column as we discuss the impacts of resistance exercise specifically on cancer, type 2 diabetes and cardiovascular disease.

Nick McClary earned his doctor of physical therapy from the University of Tennessee. He also holds a masters in business administration. He lives in Pawleys Island and works in Georgetown. Send him your health and fitness questions at: