Resistance Training Frequency Confers Greater Muscle Quality in Aged Individuals: A Brief NHANES Report

Marshall A Naimo, Ja K Gu, Christa Lilly, George A Kelley, Brent A. Baker


Background: Sarcopenia, the age-related decline in skeletal muscle mass, results in a loss of strength and functional capacity, which subsequently increases the risk of disease, disability frailty, and all-cause mortality. Skeletal muscle quality (MQ), i.e., strength per unit muscle mass, is the ability of muscle to perform its functions, and evidence indicates it is a more influential variable underlying age-related declines in muscle function than losses in muscle mass. Resistance training (RT) is known for enhancing skeletal MQ, improving health span, and reducing mortality; however, to the best of our knowledge, no studies have examined the relationship between RT frequency and MQ in an aged population. Thus, this study was designed to test the hypothesis that greater MQ in older individuals is associated with RT frequency. Methods: Utilizing data from 2,391 older adults in the National Health and Nutrition Survey (NHANES; 1999-2002), a secondary analysis of data was performed to see if an association existed between RT frequency and MQ in persons aged 55 years and older. Data were analyzed using analysis of covariance (ANCOVA) with three different models. Individuals were stratified into two groups based on how many days per week they performed RT: Insufficient (i.e., < two days per week) or sufficient (≥ two days per week). Muscle quality was calculated by taking the average peak force (Newtons) obtained from an isokinetic dynamometer and dividing it by lean mass, excluding bone mineral content (grams), obtained from dual-energy X-ray absorptiometry. The alpha level was set at <0.05. Results: For persons aged 55 and over, a statistically significant association was found between sufficient RT and greater MQ in both unadjusted as well as adjusted models that accounted for various demographic, behavioral, and clinical characteristics (p<0.05 for all). However, when limited to those 65 and older, no statistically significant associations were observed between sufficient RT and greater MQ (p>0.05 for all). When partitioned according to those 55 to 64 years of age and those 55 to 79 years, a statistically significant association was again observed (p<0.05 for all). No statistically significant associations were observed for individuals 65-79 years of age or those 80 years of age and older (p>0.05 for all). Conclusions: Sufficient amounts of RT are associated with greater MQ in selected older individuals. A need exists for future randomized controlled trials that examine the dose-response relationship between resistance training and MQ in older adults.

Full Text:



Brown JC, Harhay MO, Harhay MN. Sarcopenia and mortality among a population-based sample of community-dwelling older adults. J Cachexia Sarcopenia Muscle. 2016;7(3):290-8.

Fragala MS, Kenny AM, Kuchel GA. Muscle quality in aging: a multi-dimensional approach to muscle functioning with applications for treatment. Sports Med. 2015;45(5):641-58.

Beaudart C, Zaaria M, Pasleau F, Reginster JY, Bruyere O. Health outcomes of sarcopenia: A systematic review and meta-analysis. PLoS One. 2017;12(1):e0169548.

Kelley GA, Kelley KS. Is sarcopenia associated with an increased risk of all-cause mortality and functional disability? Exp Gerontol. 2017;96:100-3.

Seals DR, Justice JN, LaRocca TJ. Physiological geroscience: targeting function to increase healthspan and achieve optimal longevity. J Physiol. 2016;594(8):2001-24.

Baker BA. An old problem: Aging and skeletal muscle strain injury. J Sport Rehabil. 2017;26(2):180-8.

Harper S. Economic and social implications of aging societies. Science. 2014;346(6209):587-91.

Welle S. Cellular and molecular basis of age-related sarcopenia. Can J Appl Physiol. 2002;27(1):19-41.

McGregor RA, Cameron-Smith D, Poppitt SD. It is not just muscle mass: a review of muscle quality, composition and metabolism during ageing as determinants of muscle function and mobility in later life. Longev Healthspan. 2014;3(1):9.

Brown JC, Harhay MO, Harhay MN. The muscle quality index and mortality among males and females. Ann Epidemiol. 2016;26(9):648-53.

Srikanthan P, Karlamangla AS. Muscle mass index as a predictor of longevity in older adults. Am J Med. 2014;127(6):547-53.

Seals DR, Melov S. Translational geroscience: emphasizing function to achieve optimal longevity. Aging (Albany NY). 2014;6(9):718-30.

Rader EP, Naimo MA, Layner KN, Triscuit AM, Chetlin RD, Ensey J et al. Enhancement of skeletal muscle in aged rats following high-intensity stretch-shortening contraction training. Rejuvenation Res. 2017;20(2):93-102.

Cutlip RG, Baker BA, Geronilla KB, Mercer RR, Kashon ML, Miller GR et al. Chronic exposure to stretch-shortening contractions results in skeletal muscle adaptation in young rats and maladaptation in old rats. Appl Physiol Nutr Metab. 2006;31(5):573-87.

Yarasheski KE. Managing sarcopenia with progressive resistance exercise training. J Nutr Health Aging. 2002;6(5):349-56.

Tucker LA. Physical activity and telomere length in U.S. men and women: An NHANES investigation. Prev Med. 2017;100:145-51.

Cholewa J, Guimaraes-Ferreira L, da Silva Teixeira T, Naimo MA, Zhi X, de Sa RB et al. Basic models modeling resistance training: an update for basic scientists interested in study skeletal muscle hypertrophy. J Cell Physiol. 2014;229(9):1148-56.

Kraschnewski JL, Sciamanna CN, Poger JM, Rovniak LS, Lehman EB, Cooper AB et al. Is strength training associated with mortality benefits? A 15-year cohort study of US older adults. Prev Med. 2016;87:121-7.

Borde R, Hortobagyi T, Granacher U. Dose-response relationships of resistance training in healthy old adults: A systematic review and meta-analysis. Sports Med. 2015;45(12):1693-720.

Stec MJ, Thalacker-Mercer A, Mayhew DL, Kelly NA, Tuggle SC, Merritt EK et al. Randomized, four-arm, dose-response clinical trial to optimize resistance exercise training for older adults with age-related muscle atrophy. Exp Gerontol. 2017;99:98-109.

Fisher JP, Steele J, Gentil P, Giessing J, Westcott WL. A minimal dose approach to resistance training for the older adult; the prophylactic for aging. Exp Gerontol. 2017;99:80-6. About the National Health and Examination Survey. 2017.

Sabharwal S, Wilson H, Reilly P, Gupte CM. Heterogeneity of the definition of elderly age in current orthopaedic research. Springerplus. 2015;4:516.

Barbat-Artigas S, Rolland Y, Zamboni M, Aubertin-Leheudre M. How to assess functional status: a new muscle quality index. J Nutr Health Aging. 2012;16(1):67-77.

Keevil VL, Romero-Ortuno R. Ageing well: a review of sarcopenia and frailty. Proc Nutr Soc. 2015;74(4):337-47.

Lacroix A, Hortobagyi T, Beurskens R, Granacher U. Effects of supervised vs. unsupervised training programs on balance and muscle strength in older adults: A systematic review and meta-analysis. Sports Med. 2017;47(11):2341-61.

von Haehling S, Morley JE, Coats AJS, Anker SD. Ethical guidelines for publishing in the journal of cachexia, sarcopenia and muscle: update 2017. J Cachexia Sarcopenia Muscle. 2017;8(6):1081-3.



  • There are currently no refbacks.