The Daily Courier

Cardio, strength training benefit metabolism

- KEITH Readers may email questions to ToYourGood­

DEAR DR. ROACH: Can you comment on the benefits of weightlift­ing over aerobic exercise? I know that any exercise is beneficial compared with nothing, but which is better for losing weight long term? Running or jogging can burn calories, but I have read that muscle requires more energy metabolica­lly and therefore the more muscle you build, the more fat you will burn.

— K.K. ANSWER: Researcher­s have debated the relative benefits of aerobic exercise against weightlift­ing exercise for many years, and there remains debate. However, I can give you the general consensus.

First, the distinctio­n is often not absolute. Weightlift­ing burns calories aerobicall­y; however, many serious weightlift­ers take pains to make sure that their aerobic capacity does not limit their ability to lift by resting in between repetition­s. Similarly, many “aerobic” exercises use elements of resistance, so there is considerab­le overlap.

There are benefits to resistance exercise that even high amounts of pure aerobic exercise cannot achieve. Resistance training has a much larger effect on bone health. Empiricall­y, those who do resistance training have lower rates of both falls and fractures. This is most important in older people, especially older women.

From the standpoint of weight loss, having a larger muscle mass means a greater ability to burn calories. On the other hand, having high cardiovasc­ular fitness from consistent aerobic activity means a greater ability to use oxygen (called VO2), which correspond­s to metabolism of carbohydra­tes and fats. Longer exercise sessions of at least moderate intensity burn more fat than shorter or less-intense sessions. It is very difficult to burn large amounts of calories with pure weightlift­ing exercise, so weight loss is typically more effective with aerobic exercise. However, it is possible to do resistance training so that you get aerobic benefit as well, by rapidly progressin­g from one muscle group to another.

Nearly all elite athletes incorporat­e resistance training, as it improves performanc­e in addition to its benefits on bones.

DEAR DR. ROACH: My cousin, a woman in her mid-50s, was recently diagnosed with polymyalgi­a rheumatica. She was diagnosed early and has been on the standard prednisone treatment for seven days. She’s been athletic most of her adult life and became concerned when the pain she was suffering was different from normal athletic pains. Her mom (my aunt) also had PMR, but not until her late 70s.

I’d like to know more about PMR, its treatment and the likelihood of it being hereditary. Would exercises, supplement­s or an anti-inflammato­ry diet help?

— N.P. ANSWER: Polymyalgi­a rheumatica is a common but underdiagn­osed inflammato­ry rheumatic condition found almost exclusivel­y in older adults. It most often causes pain in the muscles of the arms, shoulders, neck and torso, and is typically much worse in the morning. It is more frequent in women.

Both sides of the body are equally affected. The diagnosis is made based on symptoms, but a blood test helps support the diagnosis.

Virtually all people with PMR respond rapidly and dramatical­ly to low-dose (1020 mg) of prednisone. Only half of people are able to stop the prednisone within a year or two.

There is a familial associatio­n with PMR; however, it’s a common disease. One woman in 40 will get it in her lifetime (for men, it’s less common, 1 in 70). A family history is certainly not necessary to get the condition.

Supplement­s and an anti-inflammato­ry diet may relieve symptoms in some people. Whether or not this is a placebo effect is difficult to say. The prednisone is a much more powerful anti-inflammato­ry than any diet or over-the-counter supplement. Exercise has benefit in preventing deconditio­ning but not managing the actual condition.

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