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Zone Living

Breaking down the latest research on Anti-Inflammatory Nutrition
Written By: Dr. Barry Sears, Ph. D | Creator of the Zone Diet

Written by Lisa Zeigel
on August 07, 2023

Getting through a tough workout on the leg press machine can seem daunting, but knowing that pushing through it can help prevent heart failure might make you feel better about it.   

In 2015 over 1300 patients over 30 who had suffered from coronary artery disease syndrome or had undergone an artery bypass procedure were tested for quadriceps (aka front thigh muscles) strength.  A follow-up was conducted between 3 ½ - 5 years later and the number of deaths was recorded. It was noted that individuals with a higher “Quadriceps Isometric Strength” (QIS) score, based on an isometric test of quads strength. Strength as a Predictor of Mortality in Coronary Artery Disease had a lower mortality rate than the group with a lower level of leg strength. The conclusion was that patients with a higher ratio of leg strength (concerning body weight) had a lower rate of heart failure (as well as all-cause mortality) vs. the lower-ranked QIS group.   

This may be no coincidence as another study was conducted to confirm this hypothesis: Between 2007 and 2020 over 900 patients who had severe heart conditions, including heart attack survivors, were tested for quadriceps strength through a standardized method. The risk of heart failure was determined through an analysis of other risk factors against leg strength values. Again, a rating of high or low risk was assigned to rate the probability of mortality due to myocardial infarction (MI). Slightly more than half of the group were considered high-risk. Out of both groups, 7.2% died from heart failure. The incidence of MI was double among patients with less leg strength compared to those with stronger quadriceps. The bonus finding was that a higher level of leg strength is equivalent to a 41% lower risk of a fatal heart attack compared to less strength.  Furthermore, small increases (5%) in leg strength (determined by a ratio of leg to total body weight) further decrease the risk of heart failure by as much as 11%. 

Why People Shy Away from Increasing Their Leg Strength  

The aforementioned studies sound pretty convincing, right? Yet many people seem to avoid strength training in favor of moderate, steady-state exercise (walking, etc.). Although walking is a great way to stay active, it may not do the trick as far as staving off a fatal heart event.   

One of the doctors involved in the latter study, Dr. Kentaro Kamiya, explained that after a heart attack, the heart, being a muscle, repairs itself. In this case, by adding more dense tissue surrounding it which enlarges the organ. Research is ongoing but it seems that exercise can hinder this process.  A known outcome of strength training is the release of cytokines/myokines by the working muscles. These components assist muscle repair and also have an anti-inflammatory effect.  Other benefits include blood pressure regulation, blood sugar regulation, improved insulin sensitivity, and the attenuation of a host of age-related issues.   

What to Know Before Adding Leg Strength to your Fitness Routine 

If you are ready to consider adding weight training to your heart disease prevention plan, here are some tips: 

  • Low weights and high reps are not efficient at achieving the goal of strengthening.  Heavier weights, moved slowly and carefully are even safer. You do fewer repetitions and will gain more strength.   
  • Look into using strength machines. It is highly recommended that you work with a trainer or instructor.  Pre-screen them by asking them about their training technique. State your goals, and then ask about what kind of program they would recommend for you.  

If stronger legs can help acute heart disease patients, it might be a good idea for you to add leg strengthening to your healthy heart program.

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