TRAINING|NUTRITION Reading time: 15-18 minutes
Okay folks, it has come to my attention that quite a few of you are complaining about your health while completely ignoring the most fundamental aspect of physical well-being: progressive resistance training. Here's the deal: proper strength training for health, as I'm going to outline here, is very specific in the details of its application, and there isn't much room for wiggling. Later, yes, but not at first. In addition, your approach to health must be the one that best facilitates your physical development, and this will be different for everybody depending on age, body composition, program adherence, and genetic potential. The goal of barbell training isn't to make you look like a fitness model. It's for improving your overall health through increased muscle mass, bone density, and functional strength. The idea is that strength is the foundation from which all other physical qualities derive, and that focusing on cardio alone is setting yourself up for long-term frailty and sarcopenia. I don't want you weak, but I don't care about your marathon time. If you want to run marathons, fine – worry about that later. I want you to get strong by training properly with squats, deadlifts, and presses, and health will be a side-effect, as will improved body composition.
It is common to want quick fixes and magic pills. But it must be kept in mind that the phenomenon of cause and effect cannot be argued with or circumvented by your wishes and desires. Everyone that has dealt with the medical system is familiar with the phenomenon of "prescription cascade," which happens when doctors treat symptoms rather than causes; it is not focused on creating actual health but on managing decline, and within the cascade itself there occurs a period of diminishing returns. Your average GP receives less than 24 hours of nutrition education during their entire medical training and virtually zero formal education on exercise physiology. In the UK specifically, a survey found that medical students receive an average of just 4.2 hours of nutrition education across their entire 5-6 year curriculum. And when it comes to strength training? Over 80% of UK doctors report receiving no formal training whatsoever on resistance exercise prescription. The entire medical education system is built around pharmaceutical interventions, not physical ones. They learn more about rare tropical diseases they'll never encounter than about the fundamental physical activities that could prevent most of the chronic conditions they treat daily.
We are creating an "alternative" approach with our training, and if the stress is sufficient and the recovery adequate amazing progress can occur. This is why proper resistance training makes for a more efficient health intervention: the processes by which it strengthens the body affect every system, and your health is not yet cemented in its final form. Heavy compound exercises like squats and deadlifts trigger hormonal responses that improve insulin sensitivity and increase growth hormone production naturally. The longer you wait, the further the remove from the capacity to generate significant improvement. But the stimulus/response relationship is axiomatic – you get out of it what you put into it, within the context of your ability to respond. You maximize this ability by training, eating protein, and resting in the best way possible.
But if you misinterpret what proper strength training for health means, things will not be optimum. And make no mistake – the medical system is actively working against you here. They're not malicious, just profoundly ignorant about training principles. They confuse correlation with causation constantly, warning that "lifting heavy weights raises blood pressure" without understanding the difference between acute and chronic adaptations. They'll cite injury statistics without controlling for technique or programming variables. They'll recommend machines over free weights because they seem "safer," completely missing the functional benefits of stabilization demands. The pharmaceutical industry has created a perverse system where a doctor who spends 20 minutes explaining proper nutrition and training protocols earns less than one who spends 5 minutes prescribing statins, antihypertensives, and antidepressants. Your doctor isn't qualified to give nutrition advice, yet they'll confidently tell you to "watch your salt" and "keep your cholesterol down" while knowing nothing about how dietary cholesterol actually affects serum lipids.
Here's what this misguided approach produces:
I want to get healthier and stronger. I'm currently 45 years old, and my doctor says my cholesterol is high. I've been walking on the treadmill for 3 months now, and my numbers haven't improved much. My doctor wants to put me on statins but I'm thinking I need to do more cardio to get my numbers down. Any advice you could give me I'd appreciate.
Or this:
Hello coach. I'm 50, and I just got diagnosed with osteopenia. My doctor says I need to take calcium supplements and some medication to strengthen my bones. I've been doing some light exercises with 1.5 kg dumbbells since I don't want to hurt myself. After 3 months I haven't seen much improvement in my bone scan even though I really take all my supplements. Do I need to try yoga?
If you train with proper intensity and progressive overload, and you are an adult who still has decades of life ahead, the first five or six workouts will see your strength going up significantly every time. If your first day squatting is 20 kg for 5 reps for 3 sets across, then 45 kg for 5 reps for 3 sets will be attainable within just a few workouts. Compound movements like barbell squats, deadlifts, bench press, and overhead press should form the core of your strength training program, not isolation exercises on machines. I have yet to see someone who is training and recovering correctly who is not able to make these kinds of improvements. Recovering correctly may mean eating more protein than you're used to (at least 1.6g per kg of bodyweight) and sleeping 8 hours per night, or it may mean backing off other physical activities that interfere with your strength development.
If your progress doesn't resemble this pattern, you're likely making one of several common mistakes: inadequate intensity, insufficient recovery, improper form, or inconsistent training. The program is working if you're getting stronger. It's not working if you're stagnant or regressing. Period.
In most demographics you're too sedentary if you cannot perform basic strength movements, and at risk for frailty if you cannot support your own bodyweight properly. Low testosterone levels in men, poor bone mineral density in women, and metabolic syndrome in both are often the result of insufficient resistance training, not normal aging. A training approach that avoids loading the body progressively is not the method a performance-oriented individual uses, and building significant functional strength will entail an increase in muscle mass, so these measures – since we need to choose some for you – serve well as the baseline. A bodyfat level over what's healthy for your frame means that you're headed in the direction of metabolic dysfunction and carrying around more than is efficient for moving either yourself or external loads. But really, you already know where you are when you start; people who feel the need to improve their health always know why they did it.
I know it's hazardous to prescribe strength training as the primary health intervention for everyone, but it usually works remarkably well, and in the absence of medical interventions that address root causes rather than symptoms it's about the best we can do. I also know that most of you reading this are really and truly afraid of "bulking up" or "getting hurt," and will not appreciate the advice to lift progressively heavier weights. The fact is that proper strength training – if you do not have a specific medical contraindication (you know if you do) – is not dangerous, the conditions that are required to produce and maintain good health are completely compatible with high strength and power performance levels, and those levels are necessary to stay functional as you age. Or rather, strong and thus healthy.
This probably means you. Make up your mind that, at least for the first few months, you're not going to worry about "getting too bulky" if you're already concerned about that, because looking athletic is easier to address than frailty. This current emphasis on "cardio" at the expense of all other things by most of you is the direct result of the fitness industry having done its job very well. Pictures of skinny people running marathons have been viewed by you so often in health magazines that you think it's normal, desirable, and always the best approach. The medical establishment promotes "moderate aerobic activity" because it's safe, easy to prescribe, and requires no actual expertise in physical development. You forget that there are significant downsides involved, along with enough other long-term concerns that both the fitness and medical industries should be flogged for forgetting to mention that part.
On the other hand, if you're already dealing with health issues like high blood pressure, elevated blood glucose, or osteoporosis, you have already created the conditions necessary for intervention. You'll start with more challenges than a healthy person, and health improvements have the potential to come slower for you if you train correctly because your body has accumulated problems that healthy people don't have. You still train progressively, but you start with appropriate loads and you monitor your recovery more carefully if you don't see improvements within these first couple of weeks.
After the first couple of weeks, the increase in weights becomes more methodical and 2.5 kg jumps become the rule. This provides for a long, steady linear increase in strength that has the potential to go on for months. It translates to a 7.5 kg per month increase in strength for many lifts, half as fast as the first two weeks but still very significant progress compared to doing nothing. This adds up to substantial improvements after 6-7 weeks of training for our typical adult, IF THEY HAVE BEEN RECOVERING CORRECTLY. And recovering correctly is part of the program.
If you started with significant health concerns like high cholesterol, hypertension, or pre-diabetes, they should probably be seeing improvements in biomarkers by then, more if they're younger. The key indicators that your approach is working include:
Progressive increases in the weight you can lift with good form
Improvements in relevant biomarkers (blood pressure, resting heart rate, blood sugar, etc.)
Better sleep quality and recovery capacity
Increased energy and improved mood
Better functional capacity in daily activities
Realistically, gains in strength will slow after this to an average of about 2.5-5 kg per month because most people will get sick occasionally, miss a workout or two because of work, family, etc., or get a minor injury that must be dealt with. Ideally, this does not necessarily occur, but you'll find that in most cases the extremely rapid growth in strength and health improvements experienced during the first 6-8 weeks is not sustained. But the approach does not change, because continued progress is theoretically possible for this entire adaptation period. The bumps are dealt with on a case-by-case basis, and the nutrition is held constant as long as things are improving predictably.
By 10-12 weeks, more significant improvements should be evident, resulting in better lab work, reduced medication requirements, and improved quality of life. If your doctor is still pushing the same medications without acknowledging improvements, you need a new doctor. When your entire medical system rewards treating symptoms rather than addressing causes, it's no wonder most physicians rely on outdated, pharma-sponsored "continuing education" that's designed primarily to familiarize them with the latest drugs, not the latest research on how strength training improves everything from insulin sensitivity to brain health.
After the first three or four months, adjustments will be necessary for most people based on their specific health concerns. If you have trained correctly, you will have gained quite a bit of strength, improved multiple biomarkers like HDL cholesterol, triglycerides, and fasting glucose, and potentially reduced medication needs. This means that your body is adapting positively to the stress you're imposing. This is fine; it was necessary to produce the physiological improvements. But now it's time to modify the approach to reflect your body's changing needs. Obviously progress can't go on forever at the same rate, but it must occur at first to get our goal accomplished.
Now, we need to adjust training variables like frequency and volume while maintaining intensity. At the same time, recovery protocols should evolve to match your improved capacity, accomplished by fine-tuning nutrition and sleep quality instead of just focusing on basics like you did at first. This will allow your health markers to continue improving in the direction they need to be, in the range that's appropriate for your demographic.
Along with these changes have come another few months of consistent training. The approach has not changed significantly, but the gains have begun to taper as the complexities of life and adaptation accumulate to further interrupt your good intentions. But if you have persisted with proper training and have not used these tapering results as an excuse to drop it and move "on" to the latest fad diet, or detox program, or that new miracle supplement your friend told you about, you'll still be maintaining your progress. This will mean that your health continues to improve, albeit more slowly.
Proper training drives strength acquisition, the strength increase drives health improvements. These gains approach a limit asymptotically. The younger you are the steeper the curve. Appropriate recovery is necessary, which will produce some adaptation that can be built upon later. The training stress has to constantly increase by as much as you can tolerate every workout. The load is the variable, not the number of exercises, sets, or reps. The ability to tolerate a rapid increase in load and to continue to adapt quickly slows after a few months. During this period, don't waste your opportunity to improve quickly. After this, the approach must change to reflect the reality of slower progress. I hope this clears up some of the confusion.
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