Book Review: The Barbell Prescription

The Barbell Prescription: Strength Training for Life After 40, by Jonathon M Sullivan & Andy Baker, addresses typical physical issues faced by aging humans. These include the loss of muscle mass, bone mineral loss and osteoporosis, hip fracture, loss of balance and coordination, diabetes, heart disease related to a sedentary lifestyle, and the loss of independence. It argues that these can be counteracted by regular strength training alongside sensible nutrition. It is not a simple call for more exercise, indeed the author cautions against many popular pursuits. Rather, it promotes a specific programme, providing compelling reasoning as to why older people should be adopting a regime of particular types of squats, presses and lifts in order to live well for longer.

The author is a retired medical doctor with decades of experience at an American trauma centre. He has seen the results of patients not caring for their bodies in his emergency department. He writes

“Strength training can slow, arrest or even reverse many of the degenerative effects of aging: loss of muscle and strength, brittle bones, floppy ligaments, dysfunctional joints, and the decline of mobility and balance.”

Aimed at both men and women, the book is a clarion call for avoiding the sick aging phenotype. The author avidly recommends strength training not so much as a cure as a lifetime medicine. He acknowledges that

“Biological systems are complicated, and any particular phenotype is always the result of multiple factors”

He wishes to avoid the situation where multiple drugs, with their plethora of side effects, are required to keep a body alive even if compromised.

“Most drugs treat symptoms, not disease”

“No drug in the world will ever match the power of exercise medicine”

The book is structured in three parts. The first of these presents the science in accessible format. It includes the effects on the body of eating too much, that is, more than is required to function. Explanations are provided as to how the body uses energy, including the difference between sudden demand and endurance. As well as biological energy systems, muscle tissue organisation is covered. It is clear that the author is an evangelist for strength exercises. His aim is not so much to live longer but to extend the natural healthy lifespan. The exercise regime promoted is not attempting to body build. Rather, it will assist in normal day to day activities – growing old with as much strength, vigour and function as possible.

The second part of the book covers the recommended exercises, starting with the importance of decent equipment that could rule out many facilities (the author now owns and runs a strength coaching practice).

There are three key movements to be worked on: squat, dead lift, press. These are described in some detail along with the benefits they offer the body in terms of strength, control and stability. There is emphasis on the importance of learning each exercise under qualified supervision. Having said that, the author can be scathing about the abilities of popular gym franchises’ personal trainers.

Assistance exercises are also described. These can be used to work particular muscles to enable better workouts with the key three routines.

The third part of the book looks at programming, including examples for athletes of different ages and from novice to master. Templates are provided with a note that there is no one size fits all. Patience, care and consistency are required to achieve improvement. Each person must start from where they are and then work on increasing volume and intensity. Record keeping assists in reaching training goals.

Also of importance is recovery – nutrition, hydration and sleep. The right sort of physical activity should be pursued between strength workouts. Safety is an important factor. The author does not recommend running due to its negative orthopaedic effect, or classes such as Zumba with their intense throwing around of the body. Walking, bikes and rowers are fine. Also, for reasons given, sled dragging(!).

Many variations of exercise plans are provided. At the end of this section is a chapter on the physiological differences between men and women. In summary, they are not that different. Women are generally not as strong as men but can, mostly, do the same sort of workouts with equal benefit.

The book finishes with: notes on sources for the research referenced throughout; a bibliography; a glossary of terms used.

The writing style should appeal to the target audience – those already interested in improving their health and bodies, in living better for longer rather than longevity by whatever means. It has a male slant, a gym bro vibe, but is clear and factual.

I cannot comment on the efficacy of what the author is urging but his arguments are persuasive. This was an interesting read that I will discuss with my personal trainer next time I visit the gym.

The Barbell Prescription is published by The Aasgard Company.

My copy of this book was a gift from my son.