Muscle-strengthening Exercise Epidemiology: a New Frontier in Chronic Disease Prevention

Abstract

This current opinion provides an overview of the emerging discipline of muscle-strengthening exercise epidemiology. First, we define muscle-strengthening exercise, and discuss its recent addition into the global physical activity guidelines, which were historically mainly focused on aerobic physical activity (walking, running, cycling etc.). Second, we provide an overview of the current clinical and epidemiological evidence on the associations between muscle-strengthening exercise and health, showing a reduced mortality risk, and beneficial cardiometabolic, musculoskeletal, functional and mental health-related outcomes. Third, we describe the latest epidemiological research on the assessment, prevalence, trends and correlates of muscle-strengthening exercise. An overview of recent population estimates suggests that the proportion of adults meeting the current musclestrengthening exercise guideline (10-30%; ≥ 2 sessions/week) is far lower than adults reporting meeting the aerobic exercise guideline (~50%; ≥ 150 min/week). Fourth, we discuss the complexity of muscle-strengthening exercise promotion, highlighting the need for concurrent, coordinated, and multiple-level strategies to increase populationlevel uptake/adherence of this exercise modality. Last, we explore key research gaps and strategies that will advance the field of muscle-strengthening exercise epidemiology. Our objective is to provide a case for increased emphasis on the role of muscle-strengthening exercise for chronic disease prevention, and most importantly, stimulate more research in this currently understudied area of physical activity epidemiology.

The epidemiology of muscle-strengthening exercise in Europe: A 28-country comparison including 280,605 adults

“…swimming, walking up an incline). As opposed to the current practice of using 'muscle-strengthening exercise' as an umbrella term for all its associated exercise modes, future research should consider using survey items that allow for the identification of multiple types of MSE and other physical activity/exercise modes of activity that have muscle-strengthening qualities [61].…”

Questionnaire choice affects the prevalence of recommended physical activity: an online survey comparing four measuring instruments within the same sample

“…Notwithstanding the challenges of a comparable MVPA surveillance, another crucial gap remains, as MSE recommendations have only been integrated in a few PA surveillance studies to date [65,66], which is why Strain et al accordingly called them "forgotten guidelines" [67]. MSE offer multiple health benefits such as improved physical performance and functional independence, and it assists in the prevention and management of numerous health complaints and diseases [68][69][70][71].…”

“…In addition, the prevalence for achieving both the WHO's PA recommendations combined seems to be constantly lower than for MVPA alone (some examples: Australia: 53% for MVPA, 19% for MSE, and 15% for both combined [74]; Finland: 31% for MVPA, 17% for MSE, and 11% for both [75]; Germany: 45% for MVPA, 29% for MSE, and 22% for both [20]). Due to MSE's strong relevance from a public health perspective [70], researchers should therefore choose a survey method that reflects both recommendations and the measurement of MSE should be included in population surveys [43], although MSE can currently be exclusively assessed by selfreport and not device-based [65]. Alternatively, study authors should at least distinguish accurately between MVPA and MSE when reporting the prevalence of recommended PA.…”

Correlates of and changes in aerobic physical activity and strength training before and after the onset of COVID-19 pandemic in the UK. Findings from the HEBECO study.

“…activities that increase heart rate and make one feel warmer) for at least 150 minutes/week, as well as in muscle-strengthening activity (MSA; e.g., strength/resistance training) for at least two days/week 6 . MVPA and MSA both independently and combined lower morbidity and mortality 7-1112 .…”