The following is for educational purposes only and does not constitute medical advice. Please refer to your healthcare provider before undertaking any new activity.
In the health and fitness world, we’ve all heard the mantra, “Exercise is medicine.” The wisdom and truth in these words cannot be overstated. Perhaps what needs clarity is the precise types of exercises that yield the most profound “medicine.” Here we will delve into the realm of resistance training and its integral role in promoting healthspan, or the practice of not just adding years to your life, but life to your years.
Healthspan and Longevity: The Islamic Perspective
The pursuit of a healthful lifespan finds its roots deeply entwined with the core values of Islam. The Prophet Muhammad (ﷺ) shared profound wisdom, “Take advantage of five before five: your youth before your old age, your health before your illness, your wealth before your poverty, your free time before your work, and your life before your death”1. Our time in this world is fleeting, and the vitality we sustain throughout this time is a divine blessing meant to be preserved.
The Prophet Muhammad (ﷺ) also taught us that “Actions are but by intention, and each person will have but that which he intended”. Every moment of our life can be a form of worship, including our training time. Intention in Islam (al-niyyah) is a powerful concept, and it can transform our everyday actions into acts of worship. Thus, when we train our bodies, we can make our intention to maintain the health and strength Allah SWT has blessed us with so that we can better serve Him and His creation. In this way, our time spent in exercise is not merely for our worldly benefit, but it becomes a spiritual investment, an act of gratitude and obedience to Allah.
وَ مَا خَلَقۡتُ الۡجِنَّ وَ الۡاِنۡسَ اِلَّا لِیَعۡبُدُوۡنِ
As stated in the Quran, “And I have not created the jinn and the men except that they should serve Me”.2
To fulfil this sacred purpose, we are called to maintain a state of good health, necessitating meticulous care of our bodies and minds. As we will learn, a crucial component of this care is resistance training.
The Natural Course of Aging
As we walk the path of life, our bodies undergo a natural yet relentless process of ageing. This process manifests as a progressive degeneration of our neuromuscular system, leading to a decline in muscle strength, known as dynapenia, and a loss of muscle mass, called sarcopenia. These changes can significantly impact our physical performance, overshadowing the joy and freedom of our years of retirement.3 From as early as 30 years old, an individual not participating in resistance training can begin to lose about 0.2kg (0.44lbs) of muscle a year.4 This rate doubles as individuals approach their 50s and 60s to where they may be losing 0.4kg, or almost a pound of muscle a year.5
To make matters worse, this happens on top of anabolic resistance, or the decrease in our bodies ability to use protein for muscle growth and repair, which naturally occurs as we age.6 This combination leaves many individuals significantly under-muscled in advanced age, resulting in their inability to hold their grandchild, catch themselves from falling, or even get up from a chair.7 The cycle of ageing often initiates a worrisome pattern: the loss of muscle results in a reduction of metabolic rate, or the rate at which the body consumes energy.8 This slowed metabolism can then predispose to fat accumulation. Unfortunately, this loss of metabolism places approximately 80% of men and 70% of women aged 60 and above into the less desirable categories of being overweight or obese.9 Attempting to diet through a reduced metabolic rate due to muscle loss can lead to frustration at best. The culmination of these changes can significantly impact the quality of life, leading to a decline in physical performance and independence. However, a beacon of hope exists. A growing body of scientific evidence suggests that we can mitigate the effects of ageing and enhance our healthspan through the consistent practice of resistance training.
Muscle’s Multifaceted Roles
وَ لَقَدْ خَلَقْنٰكُمْ ثُمَّ صَوَّرْنٰكُمْ ثُمَّ قُلْنَا لِلْمَلٰٓىِٕكَةِ اسْجُدُوْا لِاٰدَمَ
(al-A‘raf, 7:11)
And certainly, We did create you, then gave you shape (i.e., accomplished the phases of chemical and biological genesis and evolution of life till the completion of the physical existence of Adam).10
1: The Foundation of Strength, Stability, and Resilience
Muscles contribute significantly to our overall strength, stability, resilience, and power, ultimately serving as the foundation of our physical health. One of the key benefits of maintaining muscle strength is the role it plays in preserving independence as we age.11 Resistance training, through the process of building and maintaining muscle mass, is a powerful deterrent to conditions like osteoporosis or weakening of the bones. Osteoporosis, which is a common concern with ageing, is shown to be considerably reduced in individuals who regularly engage in resistance training.12
Muscle strength, especially grip strength, has been inversely correlated with all-cause-mortality in several studies.13 This means that higher grip strength is associated with a lower risk of dying for many reasons, as it typically indicates better overall muscular health. It’s not just about the size or the appearance of our muscles, but the power they confer on our independence and longevity by allowing us to control ourselves through space.
2: The Metabolic Engine
Our muscles play a vital role in energy metabolism.14 They are densely packed with mitochondria, the “powerhouses” of our cells. The mitochondria’s function is to generate energy for our body’s metabolic processes. By engaging in resistance training, we increase the mitochondrial density in our muscles, leading to more efficient energy production and utilisation.
Muscles are key in managing blood glucose levels.15 When muscles flex, or contract, they act like glucose sponges, soaking up more sugar from the bloodstream to fuel the hungry muscle cells, independent of insulin! They contain a channel protein called GLUT4, which is important in pulling out glucose from the bloodstream into the muscle cells. Regular resistance training increases the concentration and activity of GLUT4 and increases insulin sensitivity, leading to better long-term blood sugar management.
A bout of resistance training can increase your basal metabolic rate (BMR) for up to three days following the session, which means burning more calories even when at rest.16 By lifting 3 times a week, you can increase your daily BMR by an average of 100 calories, including on the days you rest! As you train and increase muscle mass, the energy-hungry muscles can increase your BMR on a more long-term basis. In fact, 1kg of added muscle will increase your BMR by 20 calories.
3: The Secretive Endocrine Organ
Remarkably, our muscles behave like an endocrine organ, similar to our pancreas or thyroid.17 They produce and secrete a myriad of molecules called myokines. Myokines have a significant impact on energy metabolism, cell growth, and regeneration, they play a crucial role in combating systemic inflammation.
Various myokines are produced in response to muscle contractions during resistance training. These include myostatin, which inhibits muscle growth and differentiation; follistatin and activin, both involved in muscle growth and repair; and irisin, dubbed the ‘exercise hormone,’ which stimulates the browning of white fat tissue, improves metabolic health, and can preserve cognitive function.18 Interleukins like IL-6 and IL-15 also act as myokines and have various roles, such as promoting muscle growth and mitigating inflammation.19
4: The Antioxidant Factory
Our muscles play a vital role in combating oxidative stress.20 When we exercise, our muscles experience a physiologic increase in oxidative stress. This triggers pathways that increase enzymatic responses to counteract oxidative damage. One such antioxidant is the extracellular superoxide dismutase (EcSOD).
EcSOD is expressed in skeletal muscle, and its expression can be upregulated by exercise.21 This powerful antioxidant travels through circulation and accumulates primarily in the heart and lungs, exerting its protective antioxidant effects. The antioxidant effect of EcSOD occurs differently than that of oral antioxidant supplements like fish oil, given that it’s produced within the body and specifically responds to the oxidative stress of exercise. Maintaining a regular regimen of resistance training can therefore significantly boost our body’s antioxidant capacity, shielding us from damaging oxidative stress, and promoting overall health for the long term.
Dispelling the Barriers
“I’m too Old:”
The notion that it’s too late to start resistance training is a fallacy that must be debunked. Scientific evidence unequivocally demonstrates that even older adults can build significant benefits from resistance training.22 The perceived barriers to resistance training are many and varied, particularly for older adults. Age is often the most cited reason, an excuse steeped in the assumption that with the passage of years comes an inevitable decline in physical capacity. However, evidence firmly counters this misconception. It is never too late to reap the benefits of resistance training. On the contrary, studies indicate that individuals in their 70s, 80s, and even 90s can see significant improvements in strength, balance, and flexibility following a properly supervised resistance training program.
“I’m too Busy:”
It’s not just age that hinders individuals from engaging in resistance training. Lack of time is another common excuse. But consider this: just two days of strength training per week has been shown to provide substantial benefits.23 That’s a small investment when you consider the significant return in terms of improved health and vitality.
Additionally, if a single block of time just cannot work, the idea of “exercise snacking,” or performing multiple short bouts of exercise throughout the day, is another data-backed strategy to reap the medical benefits of resistance training.24 This could look like doing a set of squats while waiting for your morning coffee to brew, or fitting in some push-ups during a commercial break. You’re breaking up what might be a longer gym session into manageable, bite-sized pieces that fit seamlessly into your existing schedule. The key here is that exercise can be flexible and adapt to your unique lifestyle and time constraints.
The next time you think you’re too busy to exercise, remember this: You’re not “too busy” to worship Allah in different ways. This is an effective way to take advantage of “your youth before your old age” and “ your health before your illness” . Engage in your training with the right intention, and your exercise becomes a form of worship, a part of your path to spiritual growth and closeness to Allah.
“A Gym is too Expensive:”
Cost and access to gym facilities are also cited as barriers, but you don’t need a professional gym with expensive equipment. Bodyweight exercises, resistance bands, and even household items can be utilised effectively in a home-based strength training regimen.25 The need for a personal trainer is also a valid concern. While professional guidance can be beneficial, especially for beginners, there are plentiful resources available online and in books to guide you through safe and effective exercises.
“I Might Get Injured:”
Fear of injury is a valid concern, especially for those with pre-existing conditions. However, when performed correctly, resistance training can actually reduce the risk of injuries by improving joint stability and enhancing overall physical resilience. In fact, resistance training has been found to improve symptoms of back pain and arthritis in some patients.26 It’s key to start slowly, prioritise proper form, and gradually increase intensity.
Effective Dosage for Health Benefits
Studies show the following as enough to provide the substantial medical benefits that we’ve discussed:27
- Aim for at least 2 sessions per week
- Incorporate exercises that target all major muscle groups
- Each session should include
- A minimum of 2-3 sets per exercise
- 7-9 repetitions per set
- Work towards lifting around 70-80% of your max weight
- Significant strength improvements can appear after 10 weeks of training, even in older adults
As diverse readers with varied histories in resistance training, it’s crucial to understand that there is no pressure to achieve a high level of performance instantly. The priority should always be the prevention of injury. After all, sustaining an injury keeps you from exercising. Injury will be more likely to occur if you increase training past what your body can adapt to at that time.28 A careful and measured approach to exercise will not only ensure safety but also create a solid foundation for a consistent fitness lifestyle.
To Conclude: Consistency
Consistency is the foundation upon which the benefits of resistance training are built. As Prophet Muhammad (ﷺ) has said, “The most beloved deed to Allah is the most regular and constant even if it were little.”29 Consistency in resistance training, therefore, will yield far greater benefits than sporadic, high-intensity workouts.
Our bodies are an Amanah (trust) from Allah, and we will be held accountable for how we treat this trust. As we navigate the myriad challenges of contemporary life, let us not lose sight of the importance of our physical health and its profound impact on our spiritual journey. After all, a strong Muslim is more beloved to Allah.
1 Deschenes, MR. “Effects of Aging on Muscle Fibre Type and Size.” Sports Med Auckl NZ 34, no. 12 (2004): 809-824.
2 Qur’an, 51:56.
3 Roubenoff, R. “Sarcopenia: A Major Modifiable Cause of Frailty in the Elderly.” J Nutr Health Aging 4, no. 3 (2000): 140-142.; Westcott, WL. “Resistance Training is Medicine: Effects of Strength Training on Health.” Curr Sports Med Rep 11, no. 4 (2012): 209-216.
4 Forbes, GB, and Halloran, E. “The Adult Decline in Lean Body Mass.” Hum Biol 48, no. 1 (1976): 161-173.
5 Forbes and Halloran, 161-173, Frontera, WR, et al. “Aging of Skeletal Muscle: A 12-Yr Longitudinal Study.” J Appl Physiol Bethesda Md 1985 88, no. 4 (2000): 1321-1326., Wang, DXM, et al. “Muscle Mass, Strength, and Physical Performance Predicting Activities of Daily Living: A Meta-Analysis.” J Cachexia Sarcopenia Muscle 11.
6 Forbes and Halloran, 161-173.
7 Beaudart, C, et al. “Health Outcomes of Sarcopenia: A Systematic Review and Meta-Analysis.” PloS One 12, no. 1 (2017)., Guan, Y, and Yan, Z. “Molecular Mechanisms of Exercise and Healthspan.” Cells 11, no. 5 (2022): 872.
8 Forbes and Halloran, “The Adult Decline”, 161-173; Dos Santos, L, et al. “Sarcopenia and Physical Independence in Older Adults: The Independent and Synergic Role of Muscle Mass and Muscle Function.” J Cachexia Sarcopenia Muscle 8, no. 2 (2017): 245-250.
9 Forbes and Halloran, 161-173.
10 Qur’an, 7:11.
11 Forbes and Halloran, 161-173, Fyfe, JJ, Hamilton, DL, and Daly, RM. “Minimal-Dose Resistance Training for Improving Muscle Mass, Strength, and Function: A Narrative Review of Current Evidence and Practical Considerations.” Sports Med Auckl NZ 52, no. 3 (2022): 463-479., Hong, AR, and Kim, SW. “Effects of Resistance Exercise on Bone Health.” Endocrinol Metab 33, no. 4 (2018): 435-444.
12 Roubenoff, R, 140-142, Forbes and Halloran, 161-173, Wang, Y, et al. “Association of Handgrip Strength with All-Cause Mortality: A Nationally Longitudinal Cohort Study in China.” J Sci Med Sport 25, no. 11 (2022): 878-883.
13 Beaudart, C, et al. 2017, López-Bueno, R, et al. “Thresholds of Handgrip Strength for All-Cause, Cancer, and Cardiovascular Mortality: A Systematic Review with Dose-Response Meta-Analysis.” Ageing Res Rev 82 (2022): 101778., Iizuka, K, Machida, T, and Hirafuji, M. “Skeletal Muscle is an Endocrine Organ.” J Pharmacol Sci 125, no. 2 (2014): 125-131.
14 Forbes and Halloran, 161-173, Mori, K. “Maintenance of Skeletal Muscle to Counteract Sarcopenia in Patients with Advanced Chronic Kidney Disease and Especially Those Undergoing Hemodialysis.” Nutrients 13, no. 5 (2021): 1538., Groennebaek, T, and Vissing, K. “Impact of Resistance Training on Skeletal Muscle Mitochondrial Biogenesis, Content, and Function.” Front Physiol 8 (2017): 713., Mang, ZA, et al. “Aerobic Adaptations to Resistance Training: The Role of Time under Tension.” Int J Sports Med 43, no. 10 (2022): 829-839., Pratley, R, et al. “Strength Training Increases Resting Metabolic Rate and Norepinephrine Levels in Healthy 50- to 65-Yr-Old Men.” J Appl Physiol Bethesda Md 1985 76, no. 1 (1994): 133-137., Hunter, GR, et al. “Resistance Training Increases Total Energy Expenditure and Free-Living Physical Activity in Older Adults.” J Appl Physiol Bethesda Md 1985 89, no. 3 (2000): 977-984., J, M, T S, Jc M, and Sm P. “Resistance Exercise, Aging, Disuse, and Muscle Protein Metabolism.” Compr Physiol 11, no. 3 (2021).
15 Forbes and Halloran, 161-173, Holten, MK, Zacho, M, Gaster, M, Juel, C, Wojtaszewski, JFP, and Dela, F. “Strength Training Increases Insulin-Mediated Glucose Uptake, GLUT4 Content, and Insulin Signaling in Skeletal Muscle in Patients with Type 2 Diabetes.” Diabetes 53, no. 2 (2004): 294-305., Flores-Opazo, M, McGee, SL, and Hargreaves, M. “Exercise and GLUT4.” Exerc Sport Sci Rev 48, no. 3 (2020): 110-118., Taaffe, DR, Pruitt, L, Reim, J, Butterfield, G, and Marcus, R. “Effect of Sustained Resistance Training on Basal Metabolic Rate in Older Women.” J Am Geriatr Soc 43, no. 5 (1995): 465-471
16 Forbes and Halloran, 161-173, Hunter, GR, et al., 2000., Park, J, Kim, J, and Mikami, T. “Exercise Hormone Irisin Prevents Physical Inactivity-Induced Cognitive Decline in Mice.” Behav Brain Res 433 (2022): 114008.
17 Forbes and Halloran, 161-173., Mori, K., 2021.
18 Mori, K., 2021, Aladag, T, Mogulkoc, R, and Baltaci, AK. “Irisin and Energy Metabolism and the Role of Irisin on Metabolic Syndrome.” Mini Rev Med Chem. Published online April 11, 2023., Calle, MC, and Fernandez, ML. “Effects of Resistance Training on the Inflammatory Response.” Nutr Res Pract 4, no. 4 (2010): 259-269.
19 Mori, K., 2021.
20 Forbes and Halloran, 161-173., Mori, K., 2021., Cotman, CW, and Berchtold, NC. “Exercise Builds Brain Health: Key Roles of Growth Factor Cascades and Inflammation.” Trends Neurosci 30, no. 9 (2007): 464-472., Yan, Z, and Spaulding, HR. “Extracellular Superoxide Dismutase, a Molecular Transducer of Health Benefits of Exercise.” Redox Biol 32 (2020): 101508.
21 Dos Santos, L, et al., 2017., Fiatarone, MA, Marks, EC, Ryan, ND, Meredith, CN, Lipsitz, LA, and Evans, WJ. “High-Intensity Strength Training in Nonagenarians. Effects on Skeletal Muscle.” JAMA 263, no. 22 (1990): 3029-3034.
22 Forbes and Halloran, 161-173., Hunter, GR., et al., 2000., J.M. et al., 2021., Westcott, WL, Winett, RA, Annesi, JJ, Wojcik, JR, Anderson, ES, and Madden, PJ. “Prescribing Physical Activity: Applying the ACSM Protocols for Exercise Type, Intensity, and Duration across 3 Training Frequencies.” Phys Sportsmed 37, no. 2 (2009): 51-58., Aguirre, LE, and Villareal, DT. “Physical Exercise as Therapy for Frailty.” Nestle Nutr Inst Workshop Ser 83 (2015): 83-92. , Nelson, ME, Fiatarone, MA, Morganti, CM, Trice, I, Greenberg, RA, and Evans, WJ. “Effects of High-Intensity Strength Training on Multiple Risk Factors for Osteoporotic Fractures. A Randomized Controlled Trial.” JAMA 272, no. 24 (1994): 1909-1914. , Hagerman, FC, Walsh, SJ, Staron, RS, et al. “Effects of High-Intensity Resistance Training on Untrained Older Men. I. Strength, Cardiovascular, and Metabolic Responses.” J Gerontol A Biol Sci Med Sci 55, no. 7 (2000): B336-346., Campbell, WW, Crim, MC, Young, VR, and Evans, WJ. “Increased Energy Requirements and Changes in Body Composition with Resistance Training in Older Adults.”, Borde, R, Hortobágyi, T, and Granacher, U. “Dose-Response Relationships of Resistance Training in Healthy Old Adults: A Systematic Review and Meta-Analysis.” Sports Med Auckl NZ 45, no. 12 (2015): 1693-1720.
23 Forbes and Halloran, 161-173., Hong and Kim, 2018., “Move More; Sit Less.” Centers for Disease Control and Prevention. Published March 23, 2023. Accessed May 10, 2023. https://www.cdc.gov/physicalactivity/basics/adults/index.htm., Turner, MN, Hernandez, DO, Cade, W, Emerson, CP, Reynolds, JM, and Best, TM. “The Role of Resistance Training Dosing on Pain and Physical Function in Individuals With Knee Osteoarthritis: A Systematic Review.” Sports Health 12, no. 2 (2020): 200-206.
24 Hong and Kim, 2018.
25 Hong and Kim, 2018.
26 Forbes and Halloran, 161-173., Tataryn, N, Simas, V, Catterall, T, Furness, J, and Keogh, JWL. “Posterior-Chain Resistance Training Compared to General Exercise and Walking Programmes for the Treatment of Chronic Low Back Pain in the General Population: A Systematic Review and Meta-Analysis.” Sports Med – Open 7, no. 1 (2021): 17., Gabbett, TJ. “The Training-Injury Prevention Paradox: Should Athletes Be Training Smarter and Harder?” Br J Sports Med 50, no. 5 (2016): 273-280.
27 Forbes and Halloran, 161-173., Hong and Kim, 2018., “Move More; Sit Less.” Centers for Disease Control and Prevention. Published March 23, 2023. Accessed May 10, 2023. https://www.cdc.gov/physicalactivity/basics/adults/index.htm., Turner, MN, Hernandez, DO, Cade, W, Emerson, CP, Reynolds, JM, and Best, TM. “The Role of Resistance Training Dosing on Pain and Physical Function in Individuals With Knee Osteoarthritis: A Systematic Review.” Sports Health 12, no. 2 (2020): 200-206.
28 Gabbett, TJ. “The Training-Injury Prevention Paradox: Should Athletes Be Training Smarter and Harder?” Br J Sports Med 50, no. 5 (2016): 273-280.
29 Sahih al-Bukhari 54:6465.
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