Muscle Strengthening, Aerobic Exercise, and Obesity: A Pooled Analysis of 1.7 Million US Adults

Abstract

Objective Both aerobic physical activity and muscle‐strengthening exercise are recommended for obesity prevention. However, at the population level, the independent and/or combined associations of these physical activity modalities with obesity are unknown. The aim of this study was to examine the associations between aerobic physical activity and muscle‐strengthening exercise with obesity among a representative sample of adults. Methods Data were pooled from four US public health surveillance surveys from 2011 to 2017. Cross‐sectional associations between adherence to the aerobic physical activity (≥ 150 min/wk) and muscle‐strengthening exercise (≥ 2 times/wk) guidelines with different classes of BMI‐defined obesity were examined using Poisson regression. Prevalence ratios are reported as both unadjusted and adjusted for sociodemographic and lifestyle characteristics. Results Data were available for 1,677,108 adults (≥ 18 years old). Compared with meeting neither guideline (reference category), meeting both guidelines was associated with the lowest adjusted prevalence ratios (APRs) for the following: Class I obesity and above (BMI ≥ 30.0 kg/m²), APR = 0.54 (95% CI: 0.53‐0.54); Class II obesity and above (BMI ≥ 35.0 kg/m²), APR = 0.32 (95% CI: 0.31‐0.33); and Class III obesity and above (BMI ≥ 40.0 kg/m²), APR = 0.21 (95% CI: 0.20‐0.21). Conclusions Among nearly 1.7 million US adults, meeting both aerobic and muscle‐strengthening exercise guidelines was associated with a lower obesity prevalence, and associations were more pronounced for higher obesity classes.