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

Obesity (Silver Spring). 2020 Feb;28(2):371-378. doi: 10.1002/oby.22673. Epub 2019 Nov 11.


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.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cross-Sectional Studies
  • Exercise / physiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscle Strength / physiology*
  • Obesity / physiopathology*
  • Surveys and Questionnaires
  • United States
  • Young Adult