Last week I looked at an analysis of adherence to a strength training intervention in adult women.  At the time I was looking at a study that was based on research done for a separate study, so I felt that it would only be right to complete the set by looking at that original study.  I don’t think anyone reading this blog will be surprised by the results, but it is helpful to sometimes go back to basics and look at the things that we all know, inherently, to be true about our strength training work.  A reminder that there really is a purpose to it, beyond how it makes us feel.

*****

Strength training and adiposity in premenopausal women: Strong, Healthy, and Empowered study

Schmitz K H, Hannan P J, Stovitz S D, Bryan C J, Warren M, Jensen M D, American Journal of Clinical Nutrition 2007; 86(3):566-572.  (Free copy of the study here.)

The study

The purpose behind this study was to “assess the efficacy of twice-weekly strength training to prevent increases in percentage body fat and intraabdominal body fat compared with a standard care comparison group among women.”  I have to say that they did a pretty good job of this.

On a separate note they also expressed an interest in finding out if the women also gained more confidence with physical activities in other areas of their life, such as recreation, household activities and transportation. (This last one confused me, but Chris told me that they probably mean carrying things about, like shopping.  This hadn’t even crossed my mind – a clear sign that I’ve been doing weight training for too long now!)

While they expressed interest in finding out about this, no further mention is made about it in this study and I suspect that data considered through interviews and discussions with participants throughout the study is discussed and considered in a separate paper: Barriers and motivators for strength training among women of color and Caucasian women.  O’Dougherty M, Dallman A, Turcotte L, Patterson J, Napolitano M A, Schmitz K H.  Women Health 2008;47(2):41-62.  Unfortunately I haven’t been able to find a free copy of this available on the internet so if anyone can get hold of a copy to send to me I’d really appreciate it.  I think it might contain the answers to questions raised by several readers of last week’s paper too – how the study actually made the women feel.

The participants

It’s worth lingering for a moment on the criteria for inclusion and exclusion in this study as they advertised widely for participants and ended up with 1,721 women to screen for it.  Of these 164 participants made it through all the criteria and were still participating by the time they were ready to start the study.  I learned from last week’s study that several women gave the free two-year membership to a gym as one of the key reasons they were motivated to apply to join the study at the start and a test group of 164 women is a really large study when you compare it to most strength and conditioning research studies looking solely at women where the test group is more often about 20 women.

In order to be included in the study the women had to meet the following criteria (as a well as a few others I’ve excluded for brevity):

• Age 25-44 years
• BMI 25-35
• A stable bodyweight with less than 10% change in the previous year
• Premenopausal
• Have a sedentary lifestyle or, at most, three weekly sessions of moderate aerobic activity
• Non-smokers
• Not be participating in a weight-loss programme
• Not have any physician-diagnosed menstrual irregularities
• Not have any significant gynecologic conditions
• Not have any positive responses to the Physical Activity Readiness Questionnaire
• Not have participated in any strength training in the previous six months
• Not currently be or have recently been pregnant or lactating
• Not be taking one of a number of listed medication types (essentially knocking out women with certain conditions)
• Not have any plans to be away for more than three consecutive weeks during the two-year study period (I bet that condition made a lot of women suddenly have an urge for a really long holiday, simply because they couldn’t take one, even if they’d never done such a long holiday before).

It’s a long list of conditions but the purpose is clear.  It drove the number of participants down from a huge number to a much smaller number of women who were, overweight or obese, largely sedentary, but otherwise in good health.

These participants were then split into two equal groups – the first undertook strength training, the second were left alone as a control group.  The control group were not given any advice other than being mailed standard American Heart Association (‘AHA’) brochures recommending thirty minutes of moderate activity each day (such as walking).  The results provide an interesting insight in itself about either the effectiveness of this advice or of how much notice is taken of this advice (although it isn’t entirely clear which is the more deficient).

The training

I’m not going to go into huge detail about the training programme as I gave a lot of information about it last week.  As a brief reminder, the participants were given a training programme involving two sessions a week – the first 16 weeks were supervised by personal trainers and then training continued unsupervised with a top-up group training session every 12 weeks to adjust the exercises that were being done. Having started these sedentary, previously untrained women on resistance machine exercises, free-weights exercises were apparently introduced over time, although the specific exercises used are not detailed, only the muscle groups they were targetting.

For the first year the training session lasted 60-90 minutes and involved nine common strength training exercises completed for three sets of eight to ten reps on each exercise, always lifting the heaviest weight possible.  In year two participants were allowed, if they wanted, to drop down to two sets of each exercise.  This is estimated as having reduced the length of the workout to 45 minutes.  Essentially year two reflected a more maintenance-style programme.

I find it interesting that participants in this group were also asked to maintain throughout the study period whatever amount of aerobic activity they had been doing before the started the study entry.  If they were already doing three lots of aerobic activity a week (the maximum possible under the criteria for participants) this would have meant quite a significant activity load once two strength training sessions were added to it.

Data collected

Unsurprisingly, with a study of this size they wanted to maximise what they learned.  Data was collected at the start as well as at the end of year one and the end of year two and they collected all sorts of data that may not have necessary seemed relevant at the time – this is why it has been possible to do so many other studies using the data collected during this study.

Clearly the main interest for this study was the body composition and, in particular the location of the fat, so the following information was collected:

• Body weight
• Body height
• Body composition, using dual-energy X-ray absorptiometry (DXA)
• Estimates of abdominal fat areas (total, subcutaneous and intraabdominal) using a single-slice computed tomography (CT) scan
• Muscle strength through a max effort bench press and leg press.  This was tested twice at each data collection point, with a two week break between each test, so that the best possible effort could be measured and the best effort of the two was then used.
• Physical activity levels through a complex method of measuring threshold activity level through a treadmill test and then using an accelerometer for two weekdays and two weekend days to measure activity that was above this threshold “sedentary” level.
• Adherence to the strength training regime
• A diet history questionnaire (a food-frequency questionnaire), although it should be noted that participants were “asked not to make any changes in their diets that might result in weight or fat gain or loss. Seasonal variations in their diets were expected and allowed.”
• Interviewer-administered surveys for the demographical divisions and at which other information was also gathered about how the women were feeling and their thoughts on the study.

Results

For this post I’m going to focus on two sets of results – the body composition and the strength gains.  Interestingly all the data is given in terms of absolutes at the start of the study and then the amount of change seen in relation to this baseline.  I looked at adherence last week and you might want to revisit that to remind yourself at how sharply adherence declined in year two, since it has some reflection in the results here.

Firstly, let’s look at the strength gains.  Unsurprisingly the control group saw a decrease in upper body strength over the two years and this is at a fairly constant rate, however it is interesting that the control group also gained leg strength during the first year (before then losing half of it again in year two).  I have no idea what caused this and the authors don’t seem inclined to consider it either.  However, when this is compared to the gains in strength for the leg press in the training group there is a huge difference.  The trained group saw a relatively huge increase in leg strength and a fairly large increase in upper body strength.  Noticeably the strength measures for the trained group also drop off in year two.  The authors sensibly put this down to a reduction in adherence to the programme in year two (adherence had dropped to 40-50% in many cases) and the fact that the programme had also moved from a strength gain programme to a maintenance programme.  Of course, if someone was only attending half the sessions and was following a maintenance programme it seems logical that they might see a decline in strength, and I think that the reasoning for the strength declines put forward by the authors are reasonable, but it is pleasing to see that this drop-off in strength is not particularly marked in the lower body.

In fact, I think it is also worth noting the fact that while they seem able to retain a lot of the leg strength despite an apparent decline in training, the upper body strength declines much more rapidly.  This is very much in line with what I saw in the gym, especially during my first few years of training when I was still a relative novice.  Upper body strength just doesn’t seem to stick as well as lower body strength.  Is this something that other women have noticed and is it specific to women or have other men noticed a more immediate decline in upper body strength when compared to lower body strength if they take a break from training?

Body composition measures are even more interesting and I’ll briefly discuss most of them in turn.

To start us off, body mass is fairly non-descript (though I’m not even going to touch BMI since I consider it a pointless measure).  As is to be expected the body mass of the training group increases steadily, but the build up of new muscle tissue will have contributed to weight gain as well as any fat that they might have put on.  A reminder to all new trainees that gaining weight doesn’t necessarily mean that the training isn’t working (after all, I now weigh 6kg more than I did a few years ago yet I definitely look and feel a lot better).  It is perhaps interesting that the control group put on the weight much more abruptly in the second year, although the reasons for this are unclear.

Body fat movements tie neatly with the strength gains, fat mass and lean mass measurement.  Those in the control group kept body fat appear to have swapped some body fat for lean mass in year one, since their body weight stayed the same but with a reduction in fat mass and gain in lean mass and reduction in body fat.  Again, the reason for this isn’t clear, although perhaps some of them took some notice of that AHA brochure sent to them at the start of the study that advised them to do more moderate intensity exercise.  However, in year two they put back on almost double the amount of fat mass that they lost in year one, so whatever they had done to lose it, this stopped working (or they stopped doing it) in year two.  I’m intrigued that the lean mass doesn’t drop again though.

Moving over to the training group there is a much bigger reduction in body fat percentage with almost double the lean mass gains seen by the control group and a statistically significant reduction in fat mass when compared to the control group.  Despite the adherence drop-off in training during year two that was so evident in the strength measurements, the lean mass mostly remained with the trainees, although body fat started to return in year two.  Despite this, the body fat did return at a slower rate than the control group were putting it on, perhaps thanks to the additional muscle the trainees were carrying in year two.

Finally, looking at the composition of that fat, I was disappointed to see that after a promising start losing some of the intraabdominal fat, the trainee group gained a large amount of this in year two while gaining a lot less subcutaneous abdominal fat.  This could be seen as a failure for strength training to work its magic until you compare it to both the adherence (poor in year two – if you want this to work you need to keep doing it) and to the control group.  The control group’s intraabdominal fat levels sky-rocket in year two and this has ennabled the authors to reach their conclusion that there is a “potential for strength training to provide sustained obesity prevention benefits over time. These findings suggest that strength training is an efficacious mode of physical activity to expand the repertory of approaches available to women for the purpose of obesity prevention.”

Potential issues with the study

With a study of this size and complexity there are always going to be confounders.  The study participants are humans and they cannot be closely monitored every minute of every day for two years.  In particular diet was only loosely monitored.

While a dietary health questionnaire was completed at each test point, which showed that participants were seeing no significant change to their total calorific intake, there is no further detail in the study about whether the macronutrient composition of those calories of the timing of those calories changed over the two years.  This is acknowledged but the authors and I feel it is only fair to let them express the problem with this in their own words:

“… the 2 most important potential confounders (diet and physical activity) did not show differences at any measurement time point. The measurement of physical activity by objective monitoring avoided the potential for desirability bias from self-report that may occur in intervention studies. No such objective monitoring of dietary changes was possible. Further, food-frequency questionnaires such as the DHQ may not be sensitive enough to capture changes in dietary pattern. The possibility that significant changes in dietary intake influenced the body composition results reported cannot be ruled out.”

A concluding thought

So there you have it, from the authors themselves.  Some of the changes in the study could be due to dietary changes rather than due to the training.  However, despite this I am inclined to the opinion that this study does provide some support for the belief that strength training on a fairly minor scale not only aids in supporting fat loss (when adhered to) but can also help prevent the natural abdominal fat gain that seems to occur over time in sedentary premenopausal women.

Overall I think it’s a helpful study.  I really would like to get my hands on the article that looks at the women’s interviews and what they were really thinking as I believe it would make a huge difference to understanding the overall changes to the women and their adherence to the training programme over the two years.  But even without that, I hope you’ve all found something to take away from the two studies I’ve looked at based on this data.

Next week I’ll see if I can find something about non-sedentary women and strength training!

Related posts:

1. Adherence to a strength training intervention in adult women
2. Influence of moderately intense strength training on flexibility in sedentary young women
3. Blog-watch: interviews with strong women

This works particularly well served up with vegetable noodles.

Paleo (primal) seafood medley

Ingredients (serves 2):
400g peeled and cooked mixed seafood (prawns, mussels, squid, scallops etc)
75g butter
1 pinch saffron powder or ground turmeric
rind and juice of ½ lemon
½ litre vegetable stock
30ml white wine vinegar
75ml double (heavy) cream, at room temperature

Directions:

1. Remove the cream from the fridge before starting to bring it to room temperature.
2. Melt the butter in a large frying pan, add the seafood and cook for 1-2 minutes.
3. Season the seafood with a little pepper, add the saffron, lemon juice and rind and mix together well.
4. Remove the seafood from the pan to a small dish and set aside somewhere to keep warm.
5. Add the vegetable stock to the pan, bring to the boil and reduce the stock by a third.  Add the vinegar and boil for a further 4 minutes until reduced.
6. Reduce the liquid to a gentle simmer, stir in the cream and leave to simmer for a final 2 minutes.
7. Plate up the seafood and pour over the sauce before serving.

Related posts:

1. Paleo recipes: mussels in a garlic cream sauce (primal)
2. Paleo recipes: leek and sweet potato gratin
3. Paleo recipes: braised fennel

So the fact that I had stalled quite horribly on my squat and was not even doing the base level with 78kg of 8×2 despite three weeks of working at it meant I needed to call it quits and drop the weight.

I dropped the weight to 75kg and have instantly started seeing some improvement.  For the first session I just did as many sets of three as I felt able to do (considering I’d done 1×3, 7×2 with 75kg on my first session back after Christmas) and then I built from that for my second squat workout.

Plan and results for last week

Workout 1:

• Back squat: 78kg – 6×2, 2×1 – so I managed 75kg 3×3, 5×2 but struggled with the third rep of the third set, hence leaving it at that.  That’s three workouts I wasted since I’d have hit that on my third workout of the year rather than my sixth if I’d just stuck with it at the start of the year.
• Partial barbell overhead press: 28kg – 4×3, 4×2 – completed with no problem.
• Chin ups: 6×3, 2×2 – again no problems.

Workout 2:

• RDL: 95kg – 7×2, 1×1 – this was an amazing workout as I felt so strong.  Suddenly it felt like I was a whole new person lifting those weights.  1×3, 7×2 – fantastic progress and finally back onto the Hepburn run.
• Hip thrusts: 135kg – 8×3 – amazingly I even managed this after all that extra work on my RDLs.

Workout 3:

• Back squat: 78kg – 7×2, 1×1 – sticking with the new progress I managed 75kg 4×3, 4×2.
• Partial barbell overhead press: 28kg – 5×3, 3×2 – I managed this although it was harder than Monday.  I think I really benefit from the day “off” on Sunday when I teach all day, since every other day I’m either working out or digging on the allotment.
• Chin ups: 7×3, 1×2 – like the overhead press this was definitely harder than Monday, just as happened last week.

Plan for this week

Workout 1:

• Back squat: 75kg – 5×3, 3×2
• Partial barbell overhead press: 28kg – 6×3, 2×2
• Chin ups: 8×3

Workout 2:

• RDL: 95kg – 2×3, 6×2
• Hip thrusts: 140kg – 8×2 – time to start progressing this properly now

Workout 3:

• Back squat: 75kg – 6×3, 2×2
• Partial barbell overhead press: 28kg – 7×3, 1×2
• Chin ups: 1×4, 7×3

Related posts:

1. Powerlifting progress 2012: week two
2. Powerlifting progress 2012: week three
3. Powerlifting progress 2011: week thirty-eight

How well would you adhere to a programme of picking this up twice a week?

It’s a really interesting study and quite readable, so I do recommend you go and have a read of it yourself, but I’ve included some of the more interesting points below.

*****

Adherence to a strength training intervention in adult women

Arikawa A Y, O’Dougherty M, Schmitz K.  J Phys Act Health 2011; 8(1):111-118. (Free copy of the study here.)

The study

This study was considering data already collected about 164 premenopausal sedentary women for the “Strong, Healthy, and Empowered” (SHE) study, reported in 2007 (Strength training and adiposity in premenopausal women: strong, healthy, and empowered study.  Schmitz KH, Hannan PJ, Stovitz SD, Bryan CJ, Warren M, Jensen MD.  Am J Clin Nutrition 2007; 86(3):566-72).  This earlier study required the women to participate in two years of strength training.  In order to assess how much the strength training made a difference it was necessary to keep note of whether the women actually did the training.

The authors of the study we’re looking at today used this subsidiary data from the 2007 study to look at whether there was any link between adherence and certain demographic variables.  The demographic variables being considered were: age, self-reported race or ethnicity, education, marital status, number and ages of children living at home and their work status.

The training programmes

For the first year participants were doing two training sessions each week, lasting 60-90 minutes each, and then recording them in a file kept at the YWCA fitness centres.

The sessions were structured with a cardio warm-up and “core” exercises followed by nine common strength training exercises and finishing with a warm-down set of stretches.  On the strength exercises participants did three sets of eight to ten reps for each exercise, always lifting the heaviest weight possible.

In year two participants were allowed, if they wanted, to drop down to two sets of each exercise.  This is estimated as having reduced the length of the workout to 45 minutes.

Strategies to support adherence

It is worth looking at the strategies employed to try and help these women adhere to the training programme.  After all, the team running the original study needed the women to do the training or they could not assess the impact.  To assist with this a number of support strategies were employed, reported as follows:

• Supervised intervention – For 16 weeks they participants did two sessions a week of supervised training with a qualified fitness professional in groups of two to six participants.
• Personal booster sessions – Access to one training session with the qualified fitness professional each month and also two group booster sessions every 12 weeks to introduce new exercises, ensure form was still correct and provide social support to the participants.
• Phone and email reminders – participants were contacted by phone or email once a week if they did not report their completed strength training sessions (their logs were checked weekly).
• Social support gatherings – twice yearly events for participants to share successes and challenges.  If I’ve learned nothing else from writing this blog, I’ve learned that women starting out on a strength training programme need a huge amount of social support, whether directly like this or through the internet.
• Incentives – free gifts like t-shirts or water bottles.
• Study website – this contained contact information for staff, methods to contact each other, success stories, ideas to help overcome challenges etc.
• Letters/email to significant others – study participants gave names of people they were close to who could encourage them.  These people were sent letters and emails explaining what they were doing and suggesting behaviours and activities that might support the participants.
• Child care – this was provided to any participant who had children age five or younger.
• Gym membership – the participants were given a two-year membership to the Minneapolis YWCA fitness centres.

This seems like a well-considered set of strategies.  However it doesn’t hit the mark with one of the biggest factors readers of this site tell me are reasons they struggle to adhere to their training programmes – a lack of time.  For this study the sessions were long enough to not be able to squeeze them into a lunch break or some other convenient window, which would have compounded any time issue too.

Provision of things like child care will have helped a little with the lack of time issue but for anyone with children over five (who would still need child care) or those with busy work lives, it would be easy enough to let time become the front-runner excuse not to train.  Even if the real problem is a lack of motivation, time can often be labelled, either rightly or wrongly, as the actual culprit for not training.

Results – supervised year one

The results can be found in full published together in a single table here.

On looking at them the most interesting part for me is that there was such good adherence while the participants were having their training sessions with a personal trainer.  Most of the adherence is above 90%, no matter how they classified the participants.

The only group where this was not the case were unmarried women with children aged 6-12 – an age group that still requires childcare and where we might assume (correctly or incorrectly) that support at home to provide this child care is less than it might be in a marital home.  These women only managed 76.7% adherence to the programme in these first few months.

Results – unsupervised year one

Even more startling is how quickly this overall adherence dropped off.  In the rest of year one, once the formal supervised training had finished, adherence dropped to 50-70% for nearly all groups, although there are some noticeable splits within that.  Most clearly when looking at race – white women maintained a 70.3% adherence while women of any other colouring only showed 48.6% adherence.  There is more discussion on this particular split later but I don’t really know what to make of it – is it cultural?

In the unsupervised part of that first year it is also helpful to look at the marital and age of children split again.  While the unmarried women with children aged 6-12 were still poor in adherence, they were safely within the main pack showing 50.9% adherence.  This suggests to me that there was much more influence from external factors on whether these women were able to adhere than pure willpower and desire to train.  They saw much less drop-off in adherence than all the other groups who dropped from an adherence above 90%.

The group who stand out this time were the unmarried women with children aged 13 or older, dropping from 96.7% to 36.3% adherence.  While this would usually imply to me something skewing the data, this pattern continues into year two and no other cut of the data reflects this skew, despite the fact that these same women must have been included in other groups (eg. college or non-college educated women).

Results – year two (unsupervised)

By year two the adherence across the board is mostly in the mid-30-50% range.  I was actually surprised by how high this adherence was in year two since it is often the second year when the love-affair with the new training routines and formats tends to finally wear off completely.

The question of race and ethnicity

Throughout this study there were results that surprised me and results that seem very easily explained.

The most extreme difference within a single comparison comes from the split between white and coloured women.  For some reason, white women, who represented 58.5% of the participants, show much greater adherence and without knowing how the other demographic characteristics split between these two groups (eg. did more coloured women have children) it is impossible to say why.

The authors gave some consideration to what might be causing this difference.  In particular whether

“the gym environment itself could be a deterrent for some participants and would particularly contribute to this division between white and coloured women.  The authors state that the “YWCA locations were in the city of Minneapolis, which had a 32% minority population […]. The YWCA mission is painted on the entrance walls of the facilities: “The YWCA of Minneapolis works to fulfill our mission of eliminating racism and empowering women.” The gym staff and membership, while majority White, reflected the diversity of the area. According to their geographic location, mission statement, staff and membership and course offerings (including hip hop, salsa and African dance, among other courses), the fitness centers did not appear to be unwelcoming to culturally diverse women. […] data gathered in focus group discussions and interviews with a subsample of intervention participants offer some perspective. Several women mentioned having joined the study in order to obtain a free gym membership. Six women of color and 5 White women explained their choice of a gym location and/or time of work out by noting disliking a crowded gym. Three women of color emphasized the gym provided a positive family experience. One said of her children: “They are all girls and I want them to know that working out is a good thing for them and they should find time as they get older.” Another found the gym “open, friendly”. Another woman of color said she had “respect” for the YWCA community, and in part frequented the gym to join that community. Two women of color had difficulties with the day care. While specific responses differed, it seems that most women did not have problems with gym-based exercise per se, but only with specific conditions: many preferred quiet, non crowded spaces.

There were, however, 6 women (2 women of color and 6 White women) who voiced discomfort with or dislike of the environment. Four specifically said they had been “intimidated” by the gym: for one woman of color it was the machines, for two (1 woman of color and 1 White woman) it was the many men working out in the weights area. The women of color noted this sense of discomfort ended once they became familiar with using the machines. A White woman said she would prefer a woman only gym: “it feels very intimidating for a woman, especially someone who’s you know who’s overweight to try and go and use the machines, when these guys are putting on all these weights, it’s just a macho thing… If they weren’t there it would feel so much more welcoming.” Another White woman, who suggested women only time periods, suggested: “women only [gym hours] and it would be like women trying to get into shape, so it wasn’t like all Barbie dolls…I would go because I would know it would be a welcoming environment”. Two White women voiced their general dislike for being in gyms without elaboration. These responses suggested that at least some women did not want to be in a social atmosphere under observation or in a male-dominated space, or perhaps indoors at all for physical activity. Most focus group responses did not indicate reservations about gym-based exercise. Instead, they emphasized their confidence in their ability to complete strength training correctly, but noted time constraints and issues of convenience.”

Given that many of these comments are coming from white women it seems unlikely that the gym conditions were the reason for this division in adherence.

The issue with parenthood and training

The authors also took time to consider the drop in adherence by women with older children too.  One of the women participating commented, “although her older children no longer required a babysitter, they needed rides to their scheduled activities.”  Another participant had commented that it was easier to adhere when her children were younger and didn’t have their own schedules.

Despite this, I do disagree with a comment from the authors that parenthood in general impacts training.  After all, those women without children didn’t always adhere as well as those women with children up to 5 years old who had access to child care.  The problem is not with being a parent per se but with what resources you have as a parent to handle the multiple commitments that this creates.

Conclusions

So what have we learned here?  Overall we have learned that there is a definite drop off over time in adherence to a training programme by overweight women.  There also seems to be a particular difficulty in training when women have children to care for – especially as those children gain a social life of their own but don’t yet have the means to get about alone.

The comments about the gym environment are especially helpful as they appear to support suspicions that I already had about gym environments putting women off training.  I have a private gym of sorts in my garage but even after years of training I still hate going into a public gym.

Some suggestions to improve this could include more women-only sessions being available in commercial gyms.  It might also be improved if gyms offered family-friendly environments where women can bring partners and children with them to workout in some way with them.  This would offer much more personal support for the women working out and also resolve some child care issues for them.  However, as a general rule in the UK nobody under age 16 is allowed into a commercial gym that has weights and until they resolve that families will not be able to workout together.

If we have friends we want to encourage to start, and then stick to, a training programme there are perhaps a few things we can do to help them.  We could offer to train with them until they have got used to the commercial gym environment and feel confident in going alone.  And even when they do feel confident, perhaps we could still go with them from time to time.  Perhaps we can offer to help with child care to allow them time to train.  These certainly appear to be the biggest barriers to adherence coming out of this particular analysis of the data.

What do you think?  Is there something I’ve missed here?  Are you a mother who has some tips you can share in the comments on how other mothers can successfully combine workouts and parenthood?  If so, I’d love to hear from you.

Related posts:

1. Strength training and adiposity in premenopausal women: Strong, Healthy, and Empowered study
2. Influence of moderately intense strength training on flexibility in sedentary young women
3. Why do women start weight training?

My preference is to use courgettes but you can also use any member of the squash family for this.

Paleo noodles

Ingredients:
1 large courgette per person

Directions:

1. Remove and discard the ends of each courgette.
2. Some people peel the skin off the vegetable.  If it is marrow or squash, which has a thicker and tougher skin, I would do this, but with a courgette the skin is relatively soft and I like the slight green colour added by leaving the skin in place.  If you would like to peel the vegetable, peel it at this stage.
3. Thinly slice each courgette lengthways, then split the slices into two piles on the chopping board and thinly slice lengthways again across the previous cuts, leaving a pile of thin strands of courgette flesh.
4. Place the strands in a pan, cover with boiling water (or bring a pan of water to the boil and add the strands once the water is ready) and simmer for 4 – 5 minutes until the strands are tender.  How long it takes will depend on how finely you managed to cut the courgettes!

When ready, drain the strands and serve up like noodles or spaghetti.

No related posts.

As the day progressed and I kept rolling every few hours for 45 minutes at a time (not really recommended – I was bruised to within an inch of my life by the end of the day) I located the problem a little further down my back to my left spinal erector where the bottom of the lat is found which made sense.  For much of the previous day I had been sat at the bottom end of a piano keyboard twisting in the lower back in order to play examples to pupils with my upper body looking as theirs should, straight onto the keyboard.

By Tuesday morning there was only the slightest hint of a twinge – mostly bruising rather than actual pain this time – so I went ahead with my workout. I felt amazing in the gym, which was perhaps partly thanks to the extra day off.  Noticeably I didn’t feel quite so marvellous for my second squat workout of the week.

Plan and results for last week

Workout 1:

• Back squat: 78kg – 6×2, 2×1 – I didn’t do this.  I just did 5×2, 3×1.  My decision to not add a rep was because several of my second reps weren’t getting to the box height but also I reduced my rest periods back down to where they were before Christmas (squats on 3 minutes rather than on a combination of 4 and 5 minutes).  I also did the doubles consecutively, so really it was an improvement on before.
• Partial barbell overhead press: 28kg – 8×3 – Ha!  This was an extremely optimistic aim.  I did what should have been the workout for today, following Hepburn, 1×3, 7×2.
• Chin ups: 4×3, 4×2 – I was really pleased that I managed full range of motion on all my reps this week.  So full in fact that I accidentally wacked the underside of my chin on the third rep of my fourth set on my way back down.  That’s got to be a good sign!

Workout 2:

• RDL: 95kg – 6×2, 2×1 – Completed as planned though my hands haven’t quite got their callouses back yet so it’s quite sore still.
• Hip thrusts: 130kg – 8×3 – Completed as planned and I really am set back on my old timing of 1.5 minutes.

Workout 3:

• Back squat: 78kg – 7×2, 1×1 – still 5×2, 3×1 I’m afraid.  I did try to do a second rep on my sixth set but only got a few inches out of the bottom before having to go back down and put the bar on the bottom pins.  Hugely tedious having to de-rack the bar and re-rack it at the right height again in the middle of a workout.  Several of my reps didn’t get to full depth either.  I wish I knew what is wrong with my squat although I am suspicious that it has something to do with poor upper back mobility that I’ve had since getting back from my walking trip over the New Year.  I can’t get the bar as low as I could before Christmas.
• Partial barbell overhead press: 30kg – 8×2 – I decided to stay with the Hepburn approach and aimed for 2×3, 6×2.  However I managed an extra rep and did 3×3, 5×2.  At least some
• Chin ups: 5×3, 3×2 – managed these, though perhaps not as easily as on Tuesday.

Plan for this week

Workout 1:

• Back squat: 78kg – 6×2, 2×1
• Partial barbell overhead press: 28kg – 4×3, 4×2
• Chin ups: 6×3, 2×2

Workout 2:

• RDL: 95kg – 7×2, 1×1
• Hip thrusts: 135kg – 8×3

Workout 3:

• Back squat: 78kg – 7×2, 1×1
• Partial barbell overhead press: 28kg – 5×3, 3×2
• Chin ups: 7×3, 1×2

Related posts:

1. Powerlifting progress 2012: week two
2. Powerlifting progress 2012: week four
3. Powerlifting progress 2011: week thirty-two

Paleo pork chops in a spicy sauce

Ingredients (serves 2 or 4, depending on how many chops you eat):
3 tbsp olive oil
4 pork chops
2 onions, thinly sliced
2 garlic cloves, peeled and crushed
2 fresh green chillies, seeded and chopped
1 inch piece of ginger root, peeled and chopped (or 1 tsp ground ginger)
1 ½ tsp cumin seeds
1 ½ tsp ground coriander
1 pint water
2 tbsp tomato purée
4 tbsp double cream (optional)

Directions:

1. Heat the oil in a pan and fry the pork chops until sealed and browned on both sides.  Remove from the pan and set aside.
2. Add the onion, garlic, chillies, ginger and spices to the pan, fry gently for a couple of minutes until the onion is starting to brown.
3. Add the water and tomato puree, bring to the boil, place the pork chops on top.  Cover the pan and simmer over a medium heat for 30 minutes.
4. If using the cream, remove it from the fridge 10 minutes before the end of cooking time to warm up to room temperature before cooking.
5. If using cream, remove the chops from the pan, stir the cream into the sauce in the pan and then return the chops.  Cover the pan again and heat through gently on a low heat for a further 5 minutes.
6. Serve up the pork chops with the sauce while still hot.

Related posts:

1. Paleo recipes: honey glazed pork
2. Paleo recipes: Chinese pork stir-fry
3. Paleo recipes: mussels in a garlic cream sauce (primal)

This was a useful study I stumbled across.  I was actually looking for another bench press study, but when I saw this study my interest was piqued.  Was this a study I could use as helpful evidence to those women who think that strength training will just get them bulky and therefore turn to yoga believing that greater flexibility equals better health?  Could this be a useful study for those of us who train to convince our non-training friends that strength training is not necessarily a bad thing?  Read on and find out.

*****

Influence of moderately intense strength training on flexibility in sedentary young women

Santos E, Rhea M R, Simão R, Dias I, de Salles B F, Novaes J, Leite T, Blair J C, Bunker D J.  Journal of Strength and Conditioning Research 2010; 24(11):3144-3149. (Free copy of the study here.)

The study

This study appears to have been trying to consolidate and delve more deeply into a collection of previous studies that had been done looking into the subject of flexibility improvements as a result of strength training.  The authors wanted to focus specifically on women in their mid-twenties whereas previous studies had either looked at other age groups or, in one case, had looked at a population of both men and women.  In the discussion section of this paper the authors are particularly dismissive of this final study pointing out that not only was there a skew to male participants (65% men and 35% women) but the resistance training group from the study was even more skewed (69% men and 31% women).  The authors believe that the influence of strength training on flexibility varies between men and women.

Unlike last week’s study, there are limited subtle comments and side-discussion from the authors of this study, however this doesn’t detract from the helpfulness of the study itself.

The participants

Whereas last week’s study used participants who had been participating in resistance training activities for a minimum of 3-5 days per week for the 6 month period immediately prior to enrolment in the study, this week’s study was looking for young women who had engaged in no physical activity for the 6 months leading up to the study and, in fact, engaged in no regular physical activity other than the study’s strength training programme while the study was taking place.  So we move from one extreme to the other – these women are truly sedentary.

Looking at the women selected they all appear to be in their mid-twenties.  The test group contained 24 women were divided into three groups of eight and the reported age of each of these groups was 26.8 ± 1.6 years, 24 ± 2.3 years and 25.4 ± 2.4 years.

Before they started the experiment the training groups were put through a week of exercise familiarisation.  This seems like an excellent idea as it would have helped prevent the possibility of injury during early training sessions and the initial testing.  However, this needs to be remembered when comparing the opening figures between the control group (who were remaining sedentary) and the training groups.

The experiment

The women were divided into three groups.  One was a control group and remained sedentary all the time, except when being tested (and presumably for some exercise familiarisation so that they knew how to do the machine bench press for the test).  The other two groups were both training groups.

Flexibility and one rep max (1RM) machine bench press were both measured at the start and end of the training period.  It’s worth noting that at the start flexibility was measured 48 to 72 hours after the initial 1RM test while at the other end of the experiment the flexibility was measured first, 48 hours after the final training session, and the 1RM was tested 48 hours after the flexibility measurements were taken.

Quite why they decided to swap these round is not certain and the authors say nothing about this.  The results are still comparable between the groups as the testing protocol was the same between groups though.

In between the opening and closing testing the training groups did 24 training sessions, three times a week over eight weeks.  The training groups did identical workouts except for a different arrangement of the exercises.  One group is described as an agonist/antagonist group and the other as an alternated strength training group.

Agonist/antagonist training group

To understand what is going on here it is necessary to understand what agonist and antagonist mean.  According to wikipedia, an agonist muscle causes movements to occur through the process of contraction.  The antagonist muscle works in conjunction with the agonist muscle, to bring the limb back to its original position.  A really good example is the upper arm where the bicep is the agonist when bending the fist up to your forehead while the triceps is then the antagonist, working to bring the arm back to its straight position.

This training group were given the following superset exercises:

• Machine seated row and machine bench press
• Machine triceps extension and machine seated arm curl
• Abdominals and trunk extension machine
• Leg extension and seated leg curl

They completed three sets of each pair, performing 10-12 reps on all except the abdominal exercise which was done for 15-20 reps.  The participants took 2 minutes rest between the supersets.

Helpfully they made the workouts progressive, increasing the weight once the participant could complete 12 reps with the weight they were working with.

If you consider the exercises being done by this group the supersets were all made up of pairs of agonist and their matching antagonist muscles, for example the triceps and arm curl which was the example I gave at the start of this section.  This is a popular way to train the upper body for a more advanced trainee but for new trainees who have not previously done these exercises it must have been utterly exhausting.

Alternated strength training group

This group did everything exactly the same as the agonist/antagonist group although if my reading of the training protocol is correct then there was only one set done of each pair and the exercises were done in a different superset order.  This time they were paired as follows:

• Machine seated row and leg extension
• Machine bench press and seated leg curl
• Machine seated arm curl and abdominals
• Machine triceps extension and trunk extension machine

This is a classic superset of arms with legs, abs or trunk each time – far less exhausting for the beginner trainee as each body part gets a longer rest between sets while the other body part is working.

Results

I have not reproduced the measurements for the six flexibility tests they carried out on the three groups pre and post experiment.  The noticeable point is that the control group saw no flexibility improvement while the two training groups both saw improvements in their flexibility.  Across the board the alternated strength training group saw greater improvement in their flexibility but by an amount that is fairly immaterial when compared to the overall increase seen by both group.  It is therefore fair to agree with the authors when they note that strength training can rapidly improve flexibility in women in their mid-twenties who were previously completely sedentary.

More interesting to me was the results on the machine bench press 1RM.  It is important to note that this is machine bench press – free-weights bench press would require far more from the stabilising muscles and would therefore take longer to reach such high numbers.  However, the difference between the agonist/antagonist group and the alternated strength training group is he and says a lot for what may be an appropriate way to train a new beginner.

The question becomes, on reading these results, whether you would want to just gain flexibility or become a bit stronger at the same time for no more effort.  If the latter is attractive to you (and why would it not be?) then alternate strength training seems to be an appropriate way to go with any previously untrained beginner.

Why the difference in results?

Disappointingly the authors don’t seem to try and address why they think the difference in results came about between the two training groups.  I have a couple of theories and have decided to share them below, although I would welcome other people’s thoughts.

Firstly, it is well known that certain leg exercises can give an instant boost to growth hormones.  It is possible that interspersing the leg exercises throughout the workout gives a better hormonal response to the upper body exercises.  However, the upper body exercises are always done first which potentially detracts from this theory.  Perhaps an interesting test would be to replicate this experiment but to have both training groups perform the alternated strength training routine with one group doing the supersets the opposite way round, performing the leg exercise then the upper body exercise, and see if the results differ between these two groups.  Would this make any difference?  Would it make a difference to the results if the 1RM test being done was a squat rather than a bench press?

Secondly, and more plausible, is the idea that these are beginners.  They have, presumably, never done these exercises before, or if they have it was some time ago.  As a result those little supporting muscles are not yet very strong.  It is likely that the agonist/antagonist workout taxes the muscles much more.  While it doesn’t stress the muscles any more, it will stress small supporting muscles that are needed for both exercises in the pair.  If they are tired from the first exercise it may not be possible to get the maximum training affect from the second exercise.  In comparison the alternated strength training group are giving those smaller muscles longer rest between sets when they want to tax them.

*****

This wasn’t necessarily the most useful study to improve my own training but I’m hoping that what I’ve learned here will help me convince a few more of my non-training friends that real strength training is not as detrimental to their overall “health” as they may believe.  Especially when this could give them some of the flexibility they go to yoga for with a few added enhancements.  It’s also given me some good ideas of the sort of workout I might prescribe to a new beginner, although perhaps with a bit more free-weights work and a bit less machine use!  Do you think you can similarly draw on this study in your own training or in convincing friends to take it up?

Related posts:

1. Adherence to a strength training intervention in adult women
2. Strength training and adiposity in premenopausal women: Strong, Healthy, and Empowered study
3. Weight training women

Paleo pine nut stuffed chicken thighs

Ingredients (serves 2):
4 large chicken thighs (or 6 small thighs)
Juice of 1 large lemon
2 spring onions, chopped
3 garlic cloves, peeled and roughly chopped
3 tbsp pine nuts
1 tbsp coriander leaves, roughly chopped

Directions:

1. First prepare the chicken thighs.  Remove the bone by cutting down the length and carefully removing the bone, leaving the chicken thigh as a long flat strip of chicken.  Place the chicken in a dish and pour over a third of the lemon juice, moving the chicken about and turning it to cover the meat all over with the juice.  Cover and leave in a cool place for 20 minutes to flavour the meat.
2. Using a hand blender, blend together the pine nuts, spring onions, garlic, remaining lemon juice (approximately two-thirds of a lemon) and herbs.  If you don’t have a hand blender then crush the pine nuts using a pestle and mortar and then add the other ingredients, finely chopped, and blend as thoroughly as possible.
3. Put the oven on to preheat to 180C.
4. When the chicken is marinated, lay the pieces out on a board, cut-side upwards, and lay a teaspoon or two of the stuffing in a line across the centre of the thigh (where the bone was).  Roll the chicken thighs back into their original shape around the stuffing and hold together using a poultry skewer or cocktail sticks.
5. Cut a large piece of foil, lay the stuffed chicken in the centre of the foil, drizzle over any remaining lemon juice from marinating the chicken, and then bring together the edges of the foil to seal the chicken in a neat package.  Place the package in the centre of the oven and bake for 35 minutes.
6. When done, remove the package and carefully unseal it.  There is likely to be hot liquid and steam inside so take care not to scald yourself.  Discard the liquid, as this is mostly water from the chicken.  The skewers can be removed before serving as the chicken should hold its shape round the stuffing once it has been cooked.

Related posts:

1. Paleo recipes: quick-cook chicken, mushroom and spinach
2. Paleo recipes: chicken stir-fry
3. Paleo recipes: stuffed lamb hearts

The interesting bit is that I am not feeling the difficulty in my legs but in my mid-back, around the base of the lats.  In the past I’ve seen huge improvement to both my RDL and back squat when I’ve been better able to engage my lats but now I can’t even convince my lats to contract, especially on the right.  To make sure I don’t lose too much acclimatisation to the heavier weights I decided to move them up a notch but, when necessary, do singles.

Plan and results for last week

Workout 1:

• Back squat: 78kg – 2,1,2,2,2,1,1,1 – this hurt a lot.
• Partial barbell overhead press: 25kg – 8×3 – easy!
• Chin ups: 2×3, 6×2

Workout 2:

• RDL: 95kg – 5×2, 3×1 – I dropped to singles because my back was popping out (at the weak point) on the second rep of my fourth and fifth set.
• Hip thrusts: 125kg – 8×3 – much better form than week one and felt easy.

Workout 3:

• Back squat: 78kg – 2,2,2,2,1,2,1,1 – an extra set of two on workout one but not in the right place.  Sets 5-8 felt completely different and hellishly hard when compared to the first four sets (though they didn’t feel easy either).
• Partial barbell overhead press: 28kg – 8×2
• Chin ups: 3×3, 5×2

Plan for this week

Workout 1:

• Back squat: 78kg – 6×2, 2×1
• Partial barbell overhead press: 28kg – 8×3
• Chin ups: 4×3, 4×2

Workout 2:

• RDL: 95kg – 6×2, 2×1
• Hip thrusts: 130kg – 8×3

Workout 3:

• Back squat: 78kg – 7×2, 1×1
• Partial barbell overhead press: 30kg – 8×2
• Chin ups: 5×3, 3×2

Related posts:

1. Powerlifting progress 2012: week four
2. Powerlifting progress 2012: week three
3. Powerlifting progress 2011: week thirty