Background
Few data exist on the association between strength training and mortality rates. We sought to examine the association between strength training and all‐cause, cardiovascular disease, and ...cancer mortality.
Methods and Results
Beginning in 2001 to 2005, 28 879 women throughout the United States (average baseline age, 62.2 years) from the Women's Health Study who were free of cardiovascular disease, diabetes mellitus, and cancer reported their physical activities, including strength training. During follow‐up (average, 12.0 years) through 2015, investigators documented 3055 deaths (411 from cardiovascular disease and 748 from cancer). After adjusting for covariables, including aerobic activity, time in strength training showed a quadratic association with all‐cause mortality (P=0.36 for linear trend; P<0.001 for quadratic trend); hazard ratios across 5 categories of strength training (0, 1–19, 20–59, 60–149, and ≥150 min/wk) were 1.0 (referent), 0.73 (95% confidence interval, 0.65–0.82), 0.71 (0.62–0.82), 0.81 (0.67–0.97), and 1.10 (0.77–1.56), respectively. A significant quadratic association was also observed for cardiovascular disease death (P=0.007) but not cancer death (P=0.41). Spline models also indicated a J‐shaped nonlinear association for all‐cause mortality (P=0.020); the point estimates of hazard ratios were <1.00 for 1 to 145 min/wk of strength training, compared with 0 min/wk, whereas hazard ratios were >1.00 for ≥146 min/wk of strength training. However, confidence intervals were wide at higher levels of strength training.
Conclusions
Time in strength training showed a J‐shaped association with all‐cause mortality in older women. A moderate amount of time in strength training seemed beneficial for longevity, independent of aerobic activity; however, any potential risk with more time (≈≥150 min/wk) should be further investigated.
1RET significantly improved worry and anxiety symptoms among young-adults with AGAD.2Reductions were larger than previous meta-analytic evidence of RET for anxiety.3RET should be encouraged for ...mental and physical health benefits.
The objective of this randomized controlled trial (RCT) was to quantify the effects of eight weeks of World Health Organization and American College of Sports Medicine guidelines-based resistance exercise training (RET) among participants meeting criteria for subclinical, or analogue-GAD (AGAD)
Forty-four participants (mean age (y): 25.4.6±4.9.2) were randomized to either an eight-week, fully-supervised, one-on-one RET intervention or wait-list control. AGAD status was determined using validated cut-scores for both the Psychiatric Diagnostic Screening Questionnaire-GAD subscale (≥6) and Penn State Worry Questionnaire (≥45). Remission, based on change in AGAD status, was assessed post-intervention, and quantified with number needed to treat (NNT). Primary analyses focused on participants missing outcome data at ≤1 time point (RET: n=12, Wait-list: n=15). RM-ANCOVA examined differences between RET and wait-list across time. Simple effects analysis decomposed significant interactions. Hedges’ d quantified magnitude of differences in change between conditions over time.
Attendance was 81% and compliance to the RET was 77%. Participants significantly increased strength (all d≥1.24, p≤0.006) with no adverse events. RET improved AGAD status (NNT=3, 95%CI: 2 to 7). Significant group X time interactions were found for worry (F(3,66) = 3.12, p≤0.043; d=0.93, 95%CI: 0.13 to 1.73) and anxiety symptoms (F(3,57.84)=2.91, ε=0.88, p≤0.045; d=0.71, 95%CI: -0.08 to 1.49). RET significantly reduced worry (mean difference=-6.49, p≤0.045) and anxiety symptoms (mean difference=-10.50, p≤0.001).
Limitations include a small sample size, and lack of attention-matched control condition.
RET significantly improved AGAD severity, and elicited large, clinically meaningful improvements in worry and anxiety symptoms among young adults with AGAD.
•Acute resistance exercise (RE) did not increase anxiety or worry symptoms.•Acute RE responses did not change after eight weeks of RE training (RET).•Despite null effects of acute RE, trait anxiety ...decreased after 8 weeks of RET.•Clinicians should encourage chronic engagement in RET for maximum benefits.
Background The effects of a single bout of resistance exercise (RE) on state anxiety and worry symptoms are understudied. Further, how resistance exercise training (RET) changes response to acute RE is unknown.
Methods Sixty-two untrained young adults (mean age (y):26.6; RET n = 27, Wait-list (WL): n = 35, 62.9% female) were randomized to an eight-week, ecologically-valid, guidelines-based RET condition, or eight-week WL control condition. Two acute RE trials were nested within the design at week one and eight, to determine RE response, and change in RE response following RET. The RET condition completed a twice-weekly RET intervention. The WL condition completed 30-minute bouts of quiet-rest at week one and eight. Two-condition (RE/quiet-rest) x two-time (pre/post) x two-session (weeks one/eight) RM-ANCOVAs examined differences between acute RE and quiet-rest pre-post and between acute sessions. Sub-analyses were conducted among young adults with analogue-Generalized Anxiety Disorder (AGAD). Primary outcomes were anxiety and worry symptoms.
Results Compliance was 99% (Rate of perceived exertion (6–20) = 14±1, Muscle soreness (1–10)=4 ± 2), with no adverse events. There were no significant three-way interactions for anxiety symptoms or worry symptoms (all p ≥ 0.51) among the total sample or AGAD sample. The magnitude of change in outcomes at each session for both samples were small and non-significant (Hedges’ d = -0.26 to 0.23).
Limitations Post-condition assessment of primary outcomes was only conducted at a single time point.
Conclusion RE did not elicit significant reductions in state anxiety or worry symptoms ten minutes post-RE. RET did not change response to acute RE. Clinicians should encourage RET for maximum anxiolytic benefits.
The mental health benefits of resistance training (RT) alone or beyond those provided by aerobic physical activity (PA) are unclear. This study aimed to determine the association between meeting ...recommendations for aerobic PA and/or RT, and symptoms of depression and/or anxiety. Participants were Australian female members of the 10,000 Steps project (n = 5180, 50.0 ± 11.5 years). Symptoms of depression and anxiety were determined using the Depression Anxiety Stress Score. Participants were grouped as ‘depression only’, ‘anxiety only’, ‘co-occurring depression and anxiety’ or ‘neither depression nor anxiety’ based on relevant subscale score (cut-points: depression≥14 points, anxiety≥10 points). The International Physical Activity Questionnaire-Long Form questionnaire was used to determine PA with an additional item to specify RT frequency. Participants were classified as adhering to ‘aerobic PA only’ (≥150 min PA/week), ‘RT only’ (RT ≥ 2 days/week), ‘aerobic PA + RT’ (≥150 min PA/week+RT ≥ 2 days/week), or ‘neither aerobic PA nor RT’ (<150 min PA/week+RT < 2 days/week). Adjusted relative risk ratios (RRR 95%CI) were estimated using multinomial logistic regression models. Relative to the ‘neither PA nor RT’ (n = 2215), the probabilities of ‘depression only’ (n = 317) and ‘co-occurring depression and anxiety’ (n = 417) were lower for the ‘aerobic PA only’ (n = 1590) (RRR = 0.74 0.56–0.97 and RRR = 0.76 0.59–0.97 respectively), and ‘both PA + RT’ (n = 974) groups (RRR = 0.61 0.43–0.86 and RRR = 0.47 0.33–0.67 respectively). There were no associations between adhering to one or both recommendations and ‘anxiety only’ (n = 317), or between ‘RT only’ (n = 401) and depression and/or anxiety. Prevention and treatment strategies including both aerobic PA and RT may provide additional benefits for depression with or without comorbid anxiety.
•Lower depression risk when meeting aerobic activity recommendation•Lower comorbid depression/anxiety risk when meeting aerobic activity recommendation•Lower depression risk when meeting aerobic and resistance training recommendations•Lower comorbid depression/anxiety risk when meeting both activity recommendations•Magnitude of risk reduction greater when meeting both activity recommendations
Physical activity can help improve the poor health-related quality of life in older adult population. Although the Physical Activity Guidelines for Americans recommend both aerobic and muscle ...strengthening activities for adults, previous studies predominantly focused on aerobic activity with limited research on muscle strengthening activities. The purpose of this cross-sectional study was to examine the relationships between meeting physical activity guidelines (i.e., aerobic activity, muscle strengthening activity) and health-related quality of life in the older adult population. Data of 87,495 older adults aged ≥65 years from the U.S. 2019 Behavioral Risk Factor Surveillance System were analyzed. Phone interviews and validated questionnaires were used to assess aerobic activity, muscle strengthening activity, and health-related quality of life. Binomial logistic regression was used to examine the relationships between meeting physical activity guidelines and health-related quality of life while adjusting for key covariates (i.e., age, sex, race, education, marital status, employment status, income, body mass index, smoking, drinking, and comorbidities). Participants meeting both or aerobic activity guideline only had significantly lower odds of reporting all components of health-related quality of life (i.e., general health, mental health, physical health, activity limitation) than those who met neither guideline (OR = 0.37-0.58) and those who met muscle strengthening activity guideline only (OR = 0.34 - 0.74). Given the stronger positive association between aerobic activity and health-related quality of life than that between muscle strengthening activity and health-related quality of life, future research should focus on promoting aerobic activity to increase health-related quality of life among older people.
•Meeting both physical activity guidelines was related to better health-related quality of life in older adults.•Meeting aerobic activity guideline only was associated with better health-related quality of life in older adults•Meeting muscle strengthening activity guideline only was associated with better general and mental health.•Meeting aerobic activity guideline contributes to the most benefits of physical activity on health-related quality of life.
Background
Latinas are disproportionately affected by low physical activity (PA) levels and related health conditions (e.g., diabetes, obesity). Few Latinas in the U.S. (17%) meet the National PA ...Guidelines for both aerobic PA and muscle-strengthening activity (MSA), yet, research to date in this population has focused almost exclusively on aerobic PA. Performing regular MSA is linked with numerous health improvements and reduced mortality; thus, may be key to addressing health disparities in this community. This study examined perspectives on engaging in MSA among Latinas enrolled in two aerobic PA RCTs.
Methods
Brief quantitative surveys were conducted to assess interest in MSA among Latinas (N = 81), along with 19 follow-up in-depth semi-structured interviews on knowledge, barriers, and facilitators for engaging in regular MSA. Interview transcripts were analyzed by two independent bilingual researchers using a directed content analysis approach.
Results
Eighty-one Latinas (18–65 years) completed the survey. Most (91%) expressed interest in learning more about MSA and 60% reported not knowing how to do MSA as a substantial MSA barrier. Interview results indicated Latinas were aware of health benefits of MSA and motivated to engage in MSA but reported barriers (e.g., perception that MSA is for men, a taboo topic, and lack of knowledge on how to do MSA).
Conclusion
This study contributes to a critical gap in PA research among Latinas. Findings will inform future culturally appropriate MSA interventions in this at-risk population. Addressing MSA and aerobic PA together in future interventions will provide a more comprehensive approach to reducing PA-related health disparities in Latinas than aerobic PA alone.
Epidemiology in the field of sports science is relatively new compared to other areas, such as exercise physiology and biomechanics; however, it is currently one of the most popular disciplines. ...Physical fitness has been a traditional topic in exercise (or physical activity) epidemiology since the late 1980s. In Japan, a pioneer study investigating “fitness epidemiology”, the Tokyo Gas Study, was published in 1993. Since then, however, trends in fitness epidemiology have changed and two main trends have emerged: large-scale studies and the subdivision of study objectives. An increasing number of large-scale cohort studies using fitness as an exposure variable have been published since the mid-2010s, confirming the findings reported by smaller-scale studies, but with higher external validity and robustness. Moreover, large-scale studies have enabled examination of the association between physical fitness and comprehensive health outcomes, including all-cause and disease-specific mortality and incidence of noncommunicable disease. However, researchers now must fill current knowledge gaps and develop more detailed study questions, which has resulted in a subdivision of study objectives. Accordingly, this short review addresses current trends in fitness epidemiology and introduces the author’s findings from a series of studies investigating the cumulative influence of physical fitness on the risk for lifestyle-related disease(s). In addition, it briefly discusses muscle-strengthening activity epidemiology, which has recently attracted attention as a new frontier beyond fitness epidemiology.
The current physical activity guidelines recommend engagement in strength activities at least 2 days per week. Currently, there is a lack of literature examining strength activities among people with ...disabilities. The purpose of this study is to estimate and compare the prevalence of engagement in strength activities and adherence to strength activity guidelines among adults with and without disabilities in the United States.
A total of 1,005,644 adults (18-80 y old) with and without disabilities from the 2013 to 2017 Behavioral Risk Factor Surveillance System were included in this secondary data analysis. Descriptive analyses were performed to describe the prevalence of strength activity behaviors of adults with and without disabilities. Logistic and Poisson regression models were performed to evaluate the relative contribution of disability status on strength activity behaviors.
A higher proportion of participants without disabilities (46.42%, 95% CI, 46.18-46.65) reported engaging in strength activities compared with participants with disabilities (30.68%, 95% CI, 30.29-31.08; P < .01). Participants with disabilities were less likely to engage in strength activities (odds ratio = 0.51, 95% CI, 0.50-0.52; adjusted odds ratio = 0.75, 95% CI, 0.73-0.77) and meet strength activity guidelines (odds ratio = 0.56, 95% CI, 0.54-0.57; adjusted odds ratio = 0.75, 95% CI, 0.73-0.77) than participants without disabilities.
Experiencing a disability is associated with lower engagement in strength activities; thus, it is important to identify effective and efficient approaches to promoting strength activities among people with disabilities.
•Underweight and obese older adults had poorer general health compared to those meeting both physical activity guidelines with normal weight.•Meeting muscle strengthening activities only or meeting ...neither physical activity guideline were more likely to have poorer physical health regardless of weight status.•Older adults who met neither physical activity guideline had higher odds of poor mental health.•Meeting muscle strengthening activity only or meeting neither PA guideline was associated with more frequent activity limitation days.
The purpose of this study was to examine how meeting physical activity (PA) guidelines (i.e., moderate-to-vigorous aerobic activity, muscle strengthening activity) and weight status were interactively related to health-related quality of life (HRQoL) among older adults.
A cross-sectional analysis was conducted using data from 87,495 older adults aged 65+ years who participated in the U.S. 2019 Behavioral Risk Factor Surveillance System. PA, weight status, and HRQoL were assessed by validated questionnaires via phone interviews. Binomial logistic regression models were used to examine the interactive effects of meeting PA guidelines and weight status on the odds of having poor HRQoL after controlling for key confounders.
Compared to participants meeting both PA guidelines and with normal weight, both underweight and obese older adults had significantly higher odds of having poor general health (OR= 1.55–6.16) regardless of meeting PA guideline status, and those meeting muscle strengthening activities only or meeting neither PA guideline reported higher odds of poor physical health (OR= 1.83–6.22) regardless of weight status. Similarly, those meeting neither PA guideline had significantly higher odds of having poor mental health (OR= 1.69–2.78) regardless of weight status, and those meeting muscle strengthening activities only or meeting neither PA guideline reported higher odds of having frequent activity limitation days (OR= 2.18–7.05).
The positive associations between moderate-to-vigorous aerobic PA and HRQoL indicate the need to promote aerobic PA in older adults. Both sex and weight status should be considered when designing PA interventions to improve HRQoL among older adults.
To investigate the relationship of moderate physical activity (MPA), vigorous physical activity (VPA), and muscle strengthening activity (MSA), independently and jointly, with all-cause, ...cardiovascular disease (CVD), and non-CVD mortality in individuals with type 2 diabetes (T2D).
This cohort study included 47,538 adults with T2D and 561,963 adults without T2D from the National Health Interview Survey 1997–2018 who provided data on self-reported physical activity (PA). Mortality data were obtained from the National Death Index through 2019. Cox regression was used to estimate hazard ratio (HR) and 95% confidence interval (CI).
In analyses mutually adjusted, versus no MPA adults with T2D, performing the recommendations of MPA (150–299 min/week) associated with lower all-cause mortality (HR, 0.72; 95% CI, 0.66–0.78), CVD mortality (HR, 0.68; 95% CI, 0.58–0.79), and non-CVD mortality (HR, 0.72; 95% CI, 0.65–0.79). Similar benefits were observed in those meeting recommendations for VPA and MSA. Higher levels of PA beyond current recommendations may provide a few additional benefits without adverse effects on mortality risk, regardless of diabetes onset age, duration of diabetes, and medication status. The joint analysis indicates that combining MSA with aerobic PA could further lower mortality risk, and lowest all-cause mortality was observed among individuals engaging in either 75–150 min/week of VPA and 1 time/week of MSA (HR, 0.30; 95% CI, 0.13–0.70) or 150–299 min/week of MPA and 1 time/week of MSA (HR, 0.33; 95% CI, 0.20–0.55).
Our study supports the current PA guidelines and suggests that there may be limited benefits gained from exercising beyond recommended levels in adults with T2D, combining recommended levels of aerobic and resistance exercises could yield the greatest benefits.
•Exceeding current physical activity recommendations may offer added benefits without increasing mortality risk in adults with type 2 diabetes.•A higher proportion of vigorous physical activity is associated with additional health benefits.•Combining recommended levels of aerobic and resistance exercises could yield the greatest benefits.
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