The epidemiology of aerobic physical activity and muscle-strengthening activity guideline adherence among 383,928 U.S. adults
Open accessAbstract
BACKGROUND: The World Health Organization's 'Global Recommendations on Physical Activity for Health' state that adults should engage in regular moderate-to-vigorous intensity aerobic physical activity (MVPA; e.g. walking, running, cycling) and muscle-strengthening activity (MSA; e.g. strength/resistance training). However, assessment of both MVPA and MSA is rare in physical activity surveillance. The aim of this study is to describe the prevalence, correlates and chronic health conditions associated with meeting the combined MVPA-MSA guidelines among a population representative sample of U.S. adults. METHODS: In this cross-sectional study, data were drawn from the U.S. 2015 Behavioral Risk Factor Surveillance System. During telephone interviews, MVPA and MSA were assessed using validated questionnaires. We calculated the proportions meeting both the global MVPA and MSA physical activity guidelines (MVPA ≥150 min/week and MSA ≥2 sessions/week). Poisson regressions with a robust error variance were used to assess: (i) prevalence ratios (PR) for meeting both guidelines across sociodemographic factors (e.g. age, sex, education, income, race/ethnicity); and (ii) PRs of 12 common chronic health conditions (e.g. diabetes, coronary heart disease, hypertension, depression) across different categories of physical activity guideline adherence (met neither [reference]; MSA only; MVPA only; met both). RESULTS: Among 383,928 adults (aged 18-80 years), 23.5% (95% CI: 20.1, 20.6%) met the combined MVPA-MSA guidelines. Those with poorer self-rated health, older adults, women, lower education/income and current smokers were less likely to meet the combined guidelines. After adjustment for covariates (e.g. age, self-rated health, income, smoking) compared with meeting neither guidelines, MSA only and MVPA only, meeting the combined MVPA-MSA guidelines was associated with the lowest PRs for all health conditions (APR range: 0.44-0.76), and the clustering of ≥6 chronic health conditions (APR = 0.33; 95% CI: 0.31-0.35). CONCLUSIONS: Eight out of ten U.S. adults do not meet the global physical activity guidelines. This study supports the need for comprehensive health promotion strategies to increase the uptake and adherence of MVPA-MSA among U.S. adults. Large-scale interventions should target specific population sub-groups including older adults, women, those with poorer health and lower education/income.
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These gendered training dynamics may be a significant contributor to the ACL injury rate disparity between women and men, given lower resistance training participation among girls/women and the importance of that activity for effective ACL injury prevention.
“These gendered training dynamics may be a significant contributor to the ACL injury rate disparity between women and men, given the well-documented lower resistance training participation rates among girls and women compared with boys and men, 40 41 and the importance of that activity for effective ACL injury prevention programmes.38”
From Anterior cruciate ligament injury: towards a gendered environmental approach (2021) · cites this paper as [40]
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Experimental — accuracy not yet measuredGirls and women participate in resistance training at a much lower rate than boys and men, and this gap is associated with strong gendered expectations of how a woman's body is supposed to look and the gender typing of weightlifting as masculine.
“However, girls and women participate in resistance training at a much lower rate than boys and men, 40 41 and this gap is associated with strong gendered expectations of how a woman's body is 'supposed' to look and the gender typing of weightlifting as masculine.23 42-45”
From Anterior cruciate ligament injury: towards a gendered environmental approach (2021) · cites this paper as [40]
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Cites
Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences
Cohen, P., Cohen, P., West, S. G., & Aiken, L. S. (2014) · Psychology Press eBooks · doi:10.4324/9781410606266 · Cited by 20,819 · see citing works
Health Behavior and Health Education: Theory, Research, and Practice
(1992) · Annals of Internal Medicine · doi:10.7326/0003-4819-116-4-350_1 · Cited by 13,211 · see citing works
Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B. A., Lamonte, M. J., Lee, I.-M., Nieman, D. C., & Swain, D. P. (2011) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e318213fefb · Cited by 9,319 · see citing works
Lee, 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 · see citing works
Global physical activity levels: surveillance progress, pitfalls, and prospects
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 · see citing works
Physical Activity and Health: A Report of the Surgeon General
(1995) · PsycEXTRA Dataset · doi:10.1037/e525162010-001 · Cited by 5,488 · see citing works
Guthold, R., Stevens, G. A., Riley, L. M., & Bull, F. C. (2018) · The Lancet Global Health · doi:10.1016/s2214-109x(18)30357-7 · Cited by 4,819 · see citing works
Progression Models in Resistance Training for Healthy Adults
(2009) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3181915670 · Cited by 4,332 · see citing works
Correlates of physical activity: why are some people physically active and others not?
Bauman, A. E., Reis, R. S., Sallis, J. F., Wells, J. C., Loos, R. J., & Martin, B. W. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60735-1 · Cited by 4,151 · see citing works
Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences
Cohen (2013) · doi:10.4324/9780203774441 · Cited by 3,228 · see citing works
Correlates of adults??? participation in physical activity: review and update
TROST, S. G., OWEN, N., BAUMAN, A. E., SALLIS, J. F., & BROWN, W. (2002) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-200212000-00020 · Cited by 3,040 · see citing works
Self-citationProgression Models in Resistance Training for Healthy Adults
(2002) · Medicine and Science in Sports and Exercise · doi:10.1097/00005768-200202000-00027 · Cited by 2,979 · see citing works
Fit Yourself and Take Your Lungs to Heart
Palange, P., & Bonini, M. (2013) · Respiration · doi:10.1159/000350831 · Cited by 2,780 · see citing works
Physical Activity, All-Cause Mortality, and Longevity of College Alumni
Paffenbarger, R. S., Hyde, R., Wing, A. L., & Hsieh, C.-C. (1986) · New England Journal of Medicine · doi:10.1056/nejm198603063141003 · Cited by 2,742 · see citing works
CORONARY HEART-DISEASE AND PHYSICAL ACTIVITY OF WORK
Morris, J. N., Heady, J. A., Raffle, P. A. B., Roberts, C., & Parks, J. W. (1953) · The Lancet · doi:10.1016/s0140-6736(53)90665-5 · Cited by 1,699 · see citing works
Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults
Moore, S. C., Lee, I.-M., Weiderpass, E., Campbell, P. T., Sampson, J. N., Kitahara, C. M., Keadle, S. K., Arem, H., Berrington de Gonzalez, A., Hartge, P., et al. (2016) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2016.1548 · Cited by 1,487 · see citing works
Progressive resistance strength training for improving physical function in older adults
Liu, C.-J., & Latham, N. K. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd002759.pub2 · Cited by 1,258 · see citing works
Physical Activity and the Prevention of Depression
Mammen, G., & Faulkner, G. (2013) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2013.08.001 · Cited by 1,122 · see citing works
The Behavioral Risk Factor Surveillance System
(2002) · PsycEXTRA Dataset · doi:10.1037/e616792007-002 · Cited by 987 · see citing works
Aune, D., Norat, T., Leitzmann, M., Tonstad, S., & Vatten, L. J. (2015) · European Journal of Epidemiology · doi:10.1007/s10654-015-0056-z · Cited by 880 · see citing works
Schoenfeld, B. J., Grgic, J., Ogborn, D., & Krieger, J. W. (2017) · Journal of Strength and Conditioning Research · doi:10.1519/jsc.0000000000002200 · Cited by 851 · see citing works
CORONARY HEART-DISEASE AND PHYSICAL ACTIVITY OF WORK
Morris, J. N., Heady, J. A., Raffle, P. A. B., Roberts, C. G., & Parks, J. W. (1953) · The Lancet · doi:10.1016/s0140-6736(53)91495-0 · Cited by 776 · see citing works
Schoenfeld, B. J., Ogborn, D., & Krieger, J. W. (2017) · Journal of Sports Sciences · doi:10.1080/02640414.2016.1210197 · Cited by 671 · see citing works
Work Activity and Coronary Heart Mortality
Paffenbarger, R. S., & Hale, W. E. (1975) · New England Journal of Medicine · doi:10.1056/nejm197503132921101 · Cited by 585 · see citing works
Test-retest reliability of four physical activity measures used in population surveys
Brown, W. J., Trost, S. G., Bauman, A. E., Mummery, K. W., & Owen, N. G. (2004) · Journal of science and medicine in sport · doi:10.1016/s1440-2440(04)80010-0 · Cited by 515 · see citing works
Self-citationPrinciples & Practice of Public Health Surveillance
Lee, L. M., Teutsch, S. M., Thacker, S. B., & Louis, M. E. S. (2010) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780195372922.001.0001 · Cited by 491 · see citing works
Coronary Heart Disease and Physical Activity of Work
Morris, J. N., & Crawford, M. D. (1958) · BMJ · doi:10.1136/bmj.2.5111.1485 · Cited by 446 · see citing works
Physical Activity Levels Among Children Aged 9-13 Years— United States, 2002
(2003) · JAMA · doi:10.1001/jama.290.10.1308 · Cited by 427 · see citing works
Principles and Practice of Public Health Surveillance
(2000) · doi:10.1093/oso/9780195138276.001.0001 · Cited by 338 · see citing works
Martyn-St James, M., & Carroll, S. (2009) · British Journal of Sports Medicine · doi:10.1136/bjsm.2008.052704 · Cited by 299 · see citing works
Adult Participation in Aerobic and Muscle-Strengthening Physical Activities — United States, 2011
Harris, C. D., Watson, K. B., Carlson, S. A., Fulton, J. E., Dorn, J. M., & Elam–Evans, L. D. (2013) · PubMed Central · Cited by 279 · see citing works
Dose–Response Relationship Between Physical Activity and Risk of Heart Failure: A Meta-Analysis
Pandey, A., Garg, S., Khunger, M., Darden, D., Ayers, C., Kumbhani, D. J., Mayo, H. G., de Lemos, J. A., & Berry, J. D. (2015) · Circulation · doi:10.1161/circulationaha.115.015853 · Cited by 272 · see citing works
(2013) · PubMed · Cited by 272 · see citing works
Ashton, R. E. M., Tew, G. A., Aning, J. J., Gilbert, S. E., Lewis, L. S., & Saxton, J. (2018) · British Journal of Sports Medicine · doi:10.1136/bjsports-2017-098970 · Cited by 254 · see citing works
Reliability and Validity of the Instrument Used in BRFSS to Assess Physical Activity
Yore, M. M., Ham, S. A., Ainsworth, B. E., Kruger, J., Reis, J. P., Kohl, H. W., & Macera, C. A. (2007) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e3180618bbe · Cited by 243 · see citing works
Zhao, R., Zhao, M., & Xu, Z. (2015) · Osteoporosis International · doi:10.1007/s00198-015-3034-0 · Cited by 223 · see citing works
Stamatakis, E., Lee, I. M., Bennie, J., Freeston, J., Hamer, M., O’Donovan, G., Ding, D., Bauman, A., & Mavros, Y. (2018) · American Journal of Epidemiology · doi:10.1093/aje/kwx345 · Cited by 198 · see citing works
Self-citationEpidemiology of Physical Activity and Exercise Training in the United States
Katzmarzyk, P. T., Lee, I.-M., Martin, C. K., & Blair, S. N. (2017) · Progress in Cardiovascular Diseases · doi:10.1016/j.pcad.2017.01.004 · Cited by 178 · see citing works
Bennie, J. A., Pedisic, Z., van Uffelen, J. G. Z., Gale, J., Banting, L. K., Vergeer, I., Stamatakis, E., Bauman, A. E., & Biddle, S. J. H. (2015) · BMC Public Health · doi:10.1186/s12889-016-2736-3 · Cited by 177 · see citing works
Self-citationEffect of Weighted Exercises on Bone Mineral Density in Post Menopausal Women A Systematic Review
Zehnacker, C. H., & Bemis‐Dougherty, A. (2007) · Journal of Geriatric Physical Therapy · doi:10.1519/00139143-200708000-00007 · Cited by 166 · see citing works
Beckett, M. W., Ardern, C. I., & Rotondi, M. A. (2015) · BMC Geriatrics · doi:10.1186/s12877-015-0007-2 · Cited by 161 · see citing works
Liu, L., Shi, Y., Li, T., Qin, Q., Yin, J., Pang, S., Nie, S., & Wei, S. (2015) · British Journal of Sports Medicine · doi:10.1136/bjsports-2015-094728 · Cited by 159 · see citing works
Physical Activity Trends—United States, 1990-1998
(2001) · JAMA · doi:10.1001/jama.285.14.1835-jwr0411-3-1 · Cited by 158 · see citing works
Grøntved, A., Pan, A., Mekary, R. A., Stampfer, M. J., Willett, W. C., Manson, J. E., & Hu, F. B. (2014) · PLoS Medicine · doi:10.1371/journal.pmed.1001587 · Cited by 150 · see citing works
Physical activity recommendations for public health: development and policy context
Oja, P., & Titze, S. (2011) · The EPMA Journal · doi:10.1007/s13167-011-0090-1 · Cited by 142 · see citing works
Stamatakis, E., Hamer, M., Tilling, K., & Lawlor, D. A. (2012) · International Journal of Epidemiology · doi:10.1093/ije/dys077 · Cited by 128 · see citing works
Factors associated with participation in resistance training: a systematic review.
Rhodes, R. E., Lubans, D. R., Karunamuni, N., Kennedy, S., & Plotnikoff, R. (2017) · British Journal of Sports Medicine · doi:10.1136/bjsports-2016-096950 · Cited by 120 · see citing works
Treating Major Depression with Physical Activity: A Systematic Overview with Recommendations
Nyström, M. B. T., Neely, G., Hassmén, P., & Carlbring, P. (2015) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2015.1015440 · Cited by 112 · see citing works
Neilson, H. K., Farris, M. S., Stone, C. R., Vaska, M. M., Brenner, D. R., & Friedenreich, C. M. (2016) · Menopause The Journal of The North American Menopause Society · doi:10.1097/gme.0000000000000745 · Cited by 98 · see citing works
Jin, K., Gullick, J. G., Neubeck, L., Koo, F. K., & Ding, D. (2017) · European Journal of Preventive Cardiology · doi:10.1177/2047487317736828 · Cited by 60 · see citing works
Milton, K., Varela, A. R., Strain, T., Cavill, N., Foster, C., & Mutrie, N. (2018) · Journal of Frailty, Sarcopenia and Falls · doi:10.22540/jfsf-03-114 · Cited by 53 · see citing works
Physical Activity Trends--United States, 1990-1998
(2001) · JAMA · doi:10.1001/jama.285.14.1835 · Cited by 45 · see citing works
Dankel, S. J., Loenneke, J. P., & Loprinzi, P. D. (2016) · Archives of cardiovascular diseases · doi:10.1016/j.acvd.2016.04.005 · Cited by 43 · see citing works
Muscle-strengthening and aerobic activities and mortality among 3+ year cancer survivors in the U.S.
Tarasenko, Y. N., Linder, D. F., & Miller, E. A. (2018) · Cancer Causes & Control · doi:10.1007/s10552-018-1017-0 · Cited by 41 · see citing works
Bennie, J. A., Ding, D., Khan, A., Stamatakis, E. A., Biddle, S., & Kim, J. (2018) · European Journal of Preventive Cardiology · doi:10.1177/2047487318817899 · Cited by 27 · see citing works
Self-citationDankel, S. J., Loenneke, J. P., & Loprinzi, P. D. (2016) · International Journal of Behavioral Medicine · doi:10.1007/s12529-016-9570-y · Cited by 25 · see citing works
Flagged first, then by citations
Research works printed but not linked: 2
- [7]WHO. Global Recommendations on Physical Activity for Health. Geneva, Switzerland; 2010. 26180873
- [41]U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition. In: 2018. DoHaHS, editor. Washington, DC: U.S.2018.
Cited by
Sorted by citations
International exercise recommendations in older adults (ICFSR): Expert consensus guidelines
Izquierdo, M., Merchant, R. A., Morley, J. E., Anker, S. D., Aprahamian, I., Arai, H., Aubertin-Leheudre, M., Bernabei, R., Cadore, E. L., Cesari, M., et al. (2021) · The Journal of nutrition, health and aging · doi:10.1007/s12603-021-1665-8 · Cited by 1,247 · see citing works
Anterior cruciate ligament injury: towards a gendered environmental approach
Parsons, J. L., Coen, S. E., & Bekker, S. (2021) · British Journal of Sports Medicine · doi:10.1136/bjsports-2020-103173 · Cited by 300 · see citing works
Izquierdo, M., de Souto Barreto, P., Arai, H., Bischoff-Ferrari, H. A., Cadore, E. L., Cesari, M., Chen, L.-K., Coen, P. M., Courneya, K. S., Duque, G., et al. (2025) · The Journal of nutrition, health and aging · doi:10.1016/j.jnha.2024.100401 · Cited by 273 · see citing works
2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia
Blumenthal, R. S., Morris, P. B., Gaudino, M., Johnson, H. M., Anderson, T. S., Bittner, V. A., Blankstein, R., Brewer, L. C., Cho, L., de Ferranti, S. D., et al. (2026) · JACC · doi:10.1016/j.jacc.2025.11.016 · Cited by 304 · see citing works
Writing Committee Members, Blumenthal, R. S., Morris, P. B., Gaudino, M., Johnson, H. M., Anderson, T. S., Bittner, V. A., Blankstein, R., Brewer, L. C., Cho, L., et al. (2026) · Circulation · doi:10.1161/cir.0000000000001423 · Cited by 122 · see citing works
Wennman, H., & Borodulin, K. (2021) · Scandinavian Journal of Medicine & Science in Sports · doi:10.1111/sms.13840 · Cited by 26 · see citing works
- Authors
- Bennie, J. A., De Cocker, K., Teychenne, M. J., Brown, W. J., & Biddle, S. J. H.
- Affiliations
- University of Southern Queensland (AU)
- Deakin University (AU)
- The University of Queensland (AU)
- Corresponding author
- Bennie, Jason A.
- Venue
- International Journal of Behavioral Nutrition and Physical Activity
- Published
- 2019-04-18
- Volume
- 16
- Issue
- 1
- Pages
- 34-34
- ISSN
- 1479-5868 (ISSN-L)
- PMC
- PMC6472085
- OpenAlex
- W2945731581
- Cited by
- 224
- References
- 56
- Citations by year
- 2026: 17 · 2025: 35 · 2024: 34 · 2023: 38 · 2022: 43 · 2021: 27 · 2020: 23 · 2019: 5 · 2018: 1
- FWCI
- 16.81
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Behavioral Nutrition and Physical Activity (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Own your potential (DEAKIN) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Social Sciences › Life-span and Life-course Studies › Sports and Physical Education Studies
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- aerobic physical activity, muscle-strengthening activity, physical activity guidelines, guideline adherence, chronic disease, sociodemographic disparities, self-rated health, smoking, health promotion, adults, United States adults, Behavioral Risk Factor Surveillance System, cardiovascular disease, diabetes mellitus, hypertension, depression, multimorbidity, health disparities, health promotion strategies
- MeSH terms
- Treatment Adherence and Compliance, Adolescent, Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Exercise Therapy, Humans, Middle Aged, United States, Exercise, Resistance Training, Young Adult
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