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Does Strength-Promoting Exercise Confer Unique Health Benefits? A Pooled Analysis of Data on 11 Population Cohorts With All-Cause, Cancer, and Cardiovascular Mortality Endpoints
Open accessAbstract
Public health guidance includes recommendations to engage in strength-promoting exercise (SPE), but there is little evidence on its links with mortality. Using data from the Health Survey for England and the Scottish Health Survey from 1994-2008, we examined the associations between SPE (gym-based and own-body-weight strength activities) and all-cause, cancer, and cardiovascular disease mortality. Multivariable-adjusted Cox regression was used to examine the associations between SPE (any, low-/high-volume, and adherence to the SPE guideline (≥2 sessions/week)) and mortality. The core sample comprised 80,306 adults aged ≥30 years, corresponding to 5,763 any-cause deaths (736,463 person-years). Following exclusions for prevalent disease/events occurring in the first 24 months, participation in any SPE was favorably associated with all-cause (hazard ratio (HR) = 0.77, 95% confidence interval (CI): 0.69, 0.87) and cancer (HR = 0.69, 95% CI: 0.56, 0.86) mortality. Adhering only to the SPE guideline was associated with all-cause (HR = 0.79, 95% CI: 0.66, 0.94) and cancer (HR = 0.66, 95% CI: 0.48, 0.92) mortality; adhering only to the aerobic activity guideline (equivalent to 150 minutes/week of moderate-intensity activity) was associated with all-cause (HR = 0.84, 95% CI: 0.78, 0.90) and cardiovascular disease (HR = 0.78, 95% CI: 0.68, 0.90) mortality. Adherence to both guidelines was associated with all-cause (HR = 0.71, 95% CI: 0.57, 0.87) and cancer (HR = 0.70, 95% CI: 0.50, 0.98) mortality. Our results support promoting adherence to the strength exercise guidelines over and above the generic physical activity targets.
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“Observational studies also suggest that combined exercise provides somewhat larger (although generally not statistically different compared with either resistance or aerobic exercise alone) risk reductions in developing clinical endpoints such as metabolic syndrome,33 hypercholesterolaemia,34 obesity,35 and CVD morbidity and mortality.36–38”
From Aerobic, resistance, or combined exercise training and cardiovascular risk profile in overweight or obese adults: the CardioRACE trial (2024) · cites this paper as [38]
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Self-citationLee, I.-M., Shiroma, E. J., Lobelo, F., Puska, P., Blair, S. N., & Katzmarzyk, P. T. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61031-9 · Cited by 8,215
Self-citation2011 Compendium of Physical Activities: A Second Update of Codes and MET Values
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Hallal, P. C., Andersen, L. B., Bull, F. C., Guthold, R., Haskell, W., & Ekelund, U. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60646-1 · Cited by 5,711
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Self-citationKyu, H. H., Bachman, V. F., Alexander, L. T., Mumford, J. E., Afshin, A., Estep, K., Veerman, J. L., Delwiche, K., Iannarone, M. L., Moyer, M. L., et al. (2016) · BMJ · doi:10.1136/bmj.i3857 · Cited by 1,272
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Research works printed but not linked: 3
- World Health Organization, 2010, Global Recommendations on Physical Activity for Health
- Joint Health Surveys Unit, 2010, Health Survey for England 2008. Volume 2 (Methodology)
- Joint Health Surveys Unit, 2014, Health Survey for England 2012. Volume 2 (Methodology)
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Zhao, M., Veeranki, S. P., Magnussen, C. G., & Xi, B. (2020) · BMJ · doi:10.1136/bmj.m2031 · Cited by 397
Loh, R., Stamatakis, E., Folkerts, D., Allgrove, J. E., & Moir, H. J. (2020) · Sports Medicine · doi:10.1007/s40279-019-01183-w · Cited by 326
Self-citationMomma, H., Kawakami, R., Honda, T., & Sawada, S. S. (2022) · British Journal of Sports Medicine · doi:10.1136/bjsports-2021-105061 · Cited by 265
Resistance Exercise Training as a Primary Countermeasure to Age-Related Chronic Disease
Mcleod, J. C., Stokes, T., & Phillips, S. M. (2019) · Frontiers in Physiology · doi:10.3389/fphys.2019.00645 · Cited by 254
Bennie, J. A., De Cocker, K., Teychenne, M. J., Brown, W. J., & Biddle, S. J. H. (2019) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/s12966-019-0797-2 · Cited by 224
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Metadata
- Authors
- Stamatakis, E., Lee, I. M., Bennie, J., Freeston, J., Hamer, M., O’Donovan, G., Ding, D., Bauman, A., & Mavros, Y.
- Affiliations
- The University of Sydney (AU)
- Brigham and Women's Hospital (US)
- Victoria University (AU)
- Loughborough University (GB)
- Corresponding author
- Stamatakis, Emmanuel
- ORCID
- Venue
- American Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-10-31
- Volume
- 187
- Issue
- 5
- Pages
- 1102-1112
- ISSN
- 0002-9262 (ISSN-L)
- 1476-6256
- OpenAlex
- W2766901730
- Cited by
- 198
- References
- 48
- Citations by year
- 2026: 14 · 2025: 22 · 2024: 17 · 2023: 16 · 2022: 32 · 2021: 29 · 2020: 33 · 2019: 17 · 2018: 18
- FWCI
- 13.75
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Victoria University Research Repository (Victoria University) (submittedVersion)
- Loughborough University Institutional Repository (Loughborough University) (submittedVersion, cc-by-nc-nd)
- Loughborough University Research Repository (Loughborough University) (submittedVersion, cc-by-nc-nd)
- Funders
- National Institute for Health Research
- National Health and Medicine Research Council
- National Institute for Health Research Leicester Biomedical Research Center
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology (medical) › Exercise and Physiological Responses
- Keywords
- resistance training, all-cause mortality, cancer mortality, cardiovascular mortality, physical activity guidelines, exercise adherence, gym-based exercise, aerobic exercise, Health Survey for England, Scottish Health Survey
- MeSH terms
- Adult, Aged, Cardiovascular Diseases, Cause of Death, England, Female, Health Promotion, Health Surveys, Humans, Male, Middle Aged, Neoplasms, Population Surveillance, Scotland, Cohort Studies, Resistance Training
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