Studies attest that strength training, as well as aerobic exercise, can help you manage and sometimes prevent conditions as varied as heart disease, diabetes, arthritis, and osteoporosis. It can also protect vitality, make everyday tasks more manageable, and help you maintain a healthy weight. Strength and Power Training for Older Adults answers your strength training questions and helps you develop a program that's right for you.
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The consumption of a high protein diet (>4 g/kg/d) in trained men and women who did not alter their exercise program has been previously shown to have no significant effect on body composition. Thus, the purpose of this investigation was to determine if a high protein diet in conjunction with a periodized heavy resistance training program would affect indices of body composition, performance and health.
Finding In this systematic review and meta-analysis of 20 randomized clinical trials enrolling 566 older adults, low-certainty evidence showed improvement in physical function and self-reported function with power training. Power training was associated with an improvement in physical function in 13 RCTs and self-reported physical function in 3 RCTs.
Meaning The findings of this study suggest that power training may be associated with a modest improvement in physical function compared with traditional strength training in healthy, community-living older adults.
Importance Strength training exercise is recommended for improving physical function in older adults. However, whether strength training (lifting and lowering weights under control) and power training (PT) (lifting weights fast and lowering under control) are associated with improved physical function in older adults is not clear.
Conclusions and Relevance In this systematic review and meta-analysis, PT was associated with a modest improvement in physical function compared with traditional strength training in healthy, community-living older adults. However, high-quality, larger RCTs are required to draw more definitive conclusions.
Gender is often neglected in health systems, yet health systems are not gender neutral. Within health systems research, gender analysis seeks to understand how gender power relations create inequities in access to resources, the distribution of labour and roles, social norms and values, and decision-making. This paper synthesises findings from nine studies focusing on four health systems domains, namely human resources, service delivery, governance and financing. It provides examples of how a gendered and/or intersectional gender approach can be applied by researchers in a range of low- and middle-income settings (Cambodia, Zimbabwe, Uganda, India, China, Nigeria and Tanzania) to issues across the health system and demonstrates that these types of analysis can uncover new and novel ways of viewing seemingly intractable problems.
The implications of the diverse examples of gender and health systems research highlighted indicate that policy-makers, health practitioners and others interested in enhancing health system research and delivery have solid grounds to advance their enquiry and that one-size-fits-all heath interventions that ignore gender and intersectionality dimensions require caution. It is essential that we build upon these insights in our efforts and commitment to move towards greater equity both locally and globally.
Gender is often neglected in health systems, yet health systems are not gender neutral. Gender is a key social stratifier, affecting health system needs, experiences and outcomes at all levels [1,2,3]. Within health systems research, gender analysis seeks to understand how gender power relations create inequities in access to resources, the distribution of labour and roles, social norms and values, and decision-making [1, 3,4,5]. An intersectional gender analysis [6], which aims to promote researcher and activist engagement to bring about positive transformation in the structures and institutions of power, explores how gender intersects with other determinants of social stratification, such as race, class, age, (dis)ability, education, etc., to create different experiences of privilege and/or marginalisation within the health system [7]. Intersectionality offers an analysis that augments our understanding of gender, and how gender and other social stratifiers are mutually constituted and intersect in dynamic and interactive ways [8, 9].
Within the health system, gender power relations affect, for example, the health workforce (whether informal care provided at home is recognised and supported; whether recruitment, retention, promotion and harassment policies take gender bias into consideration), health financing (the extent of financial protection availability to different groups, out-of-pocket expenditures) and governance (the systems of daily management, leadership, accountability and the extent to which policies incorporate gender considerations) [1, 4, 11,12,13,14].
The research used a combination of mixed, quantitative, qualitative and participatory methods, demonstrating the applicability of diverse research methods for gender and intersectional analysis. Within each study, the researchers adapted and applied a variety of gender and intersectional tools to assist with data collection and analysis, including different gender frameworks. Some researchers used participatory tools, such as photovoice and life histories, to prompt deeper and more personal reflections on gender norms from respondents. Others used conventional qualitative methods (in-depth interviews, focus group discussion (FGDs)). Care was also taken to think about multiple power relations that guide interactions within the particular communities of interest throughout the research process, for example, within sampling techniques (i.e. who is included and excluded from the research process), the positionality of the researcher and how this affects the data collection process, separating different categories of people during FGDs (i.e. conducting separate FGDs with older and younger women or with health managers and community health workers), and considering where participants, such as health workers and community members, would feel most comfortable for interviews (e.g. health workers at health facility and community members at community offices like village offices), as well as bringing gender and intersectionality lenses to the analysis process (e.g. exploring how gender, age and location shape progression opportunities within the realities of post-conflict contexts).
Reflexivity is a central tenant of gender and intersectionality research and we recognise that our positionality will influence interpretation of the individual study findings and the core themes identified across the studies. The authors come from diverse backgrounds and locations. The RinGs Consortium Steering Committee members are from both high-income and low- and middle-income countries, and the study contributors are from low- and middle-income countries. Each study contributor was a national and resident of the country in which the study was conducted. Authors have varied sexes, ages, and ethnic and national backgrounds, as well as different types and levels of graduate training. For many of the study contributors, this was the first time they had used gender analysis as a lens within health system research, while others were more experienced. All study contributors were supported by the RinGs Steering Committee throughout the data collection and analysis process, the members of which have extensive experience in using gender analysis within health and health systems research. We feel that the diversity of locations and identities of the authors helped to provide a more robust analysis across the nine studies.
The studies in Zimbabwe and Uganda exploring human resources for health both showed how gendered norms shaped the types of employment men and women had within the health system, and what roles were considered feasible and acceptable. Within Zimbabwe, for example, participants not only reported that the health sector was largely feminised, with women accounting for the majority of healthcare workers, but also that there were gender imbalances within the different professions in Zimbabwe, stemming from the careers men and women tended to pursue and the training recruitment processes.
The Zimbabwean case study also found that access to training opportunities and career development were shaped by gender roles and norms at the household and institutional levels. Men were able to take up training opportunities, some of which were self-funded, whereas women were often unable to pursue these opportunities due to gendered family responsibilities and a lack of personal financial resources. In terms of relocation for career development or new opportunities, women were much more likely to follow their husbands. Here, gender intersected with marital status in a way that was advantageous for men but disadvantageous for women. This meant that female health workers often had to resign from their jobs to seek new ones, sometimes in a different sector (such as moving from the government to the mission sector), sacrificing the accruing of years of service required to access training and the opportunities for promotion. This affected their career levels; many reported re-joining the health sector in junior/lower posts, and therefore a loss of pay/accepting lower pay, delaying their time for promotion, upgrading and/or upskilling.
Intermittent fasting (IF) is an increasingly popular dietary approach used for weight loss and overall health. While there is an increasing body of evidence demonstrating beneficial effects of IF on blood lipids and other health outcomes in the overweight and obese, limited data are available about the effect of IF in athletes. Thus, the present study sought to investigate the effects of a modified IF protocol (i.e. time-restricted feeding) during resistance training in healthy resistance-trained males. 2ff7e9595c
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