The Importance of Resistance Exercise: Rethinking Old Assumptions About Health

As health awareness has grown worldwide, aerobic exercise (AE) has long been regarded as an important way to improve health. The evidence base supporting the health benefits of AE is far larger than that for resistance exercise (RE), and AE has become the core of most exercise guidelines. In recent years, however, a growing body of research on resistance exercise (RE) has found that its role in promoting health should not be overlooked. Research suggests it may be as beneficial as aerobic exercise for some outcomes, and in certain situations may be associated with additional benefit.

The health benefits of resistance exercise

Resistance exercise, which usually includes weightlifting, resistance bands, and bodyweight training, can affect health in a variety of ways, including:

• Improving chronic disease

In studies, resistance exercise was associated with lower HbA1c in people with type 2 diabetes, and some research suggests it may be linked to a lower incidence of diabetes (these are study-level associations and do not predict individual outcomes). In addition, resistance exercise offers notable benefits for people with cancer, including reducing cancer-related fatigue and improving treatment side effects.

• Preventing functional decline and slowing aging

Aging is accompanied by a decline in muscle strength and muscle mass, a phenomenon known as sarcopenia. Resistance exercise not only helps reduce the occurrence of sarcopenia but can also more efficiently improve muscle strength and power, slowing functional decline and lowering the risk of falls.

• Lowering mortality risk

Research shows that regular participation in resistance exercise is associated with a significantly lower risk of cardiovascular disease, cancer, and all-cause mortality, and that combining it with aerobic exercise can achieve greater health benefits. RE appears safe and feasible in breast, colorectal, and prostate cancer. Across the studies reviewed, combining resistance and aerobic exercise was associated with the lowest hazard ratios for all-cause mortality, with either type alone also linked to lower risk than being inactive (trial results, which do not predict individual outcomes).

The complementary nature of resistance and aerobic exercise

The traditional view holds that aerobic exercise mainly improves cardiorespiratory function, while resistance exercise builds muscle strength. Recent research has found that the health effects of the two overlap substantially and are complementary. The benefits conferred by aerobic and resistance exercise are, in some cases, the exclusive domain of each type of exercise. For example, cardiorespiratory fitness (CRF) comes mainly from aerobic exercise, while muscle strength and power come from resistance exercise. From a health standpoint, resistance and aerobic exercise may have more in common than not, and these forms of exercise are additive or synergistic in their benefits.

• Cardiovascular health: Resistance exercise has a positive effect on vascular function and metabolic health, particularly in lowering blood pressure and improving insulin sensitivity.
• Mental health: Like aerobic exercise, resistance exercise can reduce stress and anxiety and improve overall mental health.

Breaking a myth: the minimum effective dose

As the global population ages rapidly, resistance training becomes even more important for older adults. Resistance training is one of the most studied approaches for preventing and slowing muscle loss. It can improve balance, reduce the risk of falls, increase the capacity for daily activities, and help maintain the ability to live independently, and research suggests it may have a positive effect on cognitive function.

Many people worry that resistance training takes a great deal of time or is very strenuous, but research shows:

• Just 30 to 60 minutes per week can bring significant health benefits.

• Weight-training equipment is not necessarily required; resistance bands or bodyweight can also be used.

• Resistance training appears relatively safe even for older adults in the populations studied.

• Beginners can start with simpler movements and progress gradually.

Strategies to encourage participation in resistance exercise

Although the health benefits of resistance exercise are many, participation rates remain markedly lower than for aerobic exercise. Here are several suggestions for improving participation:

• Set achievable goals

When starting resistance exercise, it is essential to set simple, attainable goals. For example, two resistance sessions per week, each with 8 to 12 repetitions of basic movements covering the major muscle groups.

• Emphasize health and emotional benefits

Fitness professionals can explain to clients how resistance exercise improves health markers while also bringing emotional rewards, such as greater confidence and a sense of accomplishment.

• Lower the barrier to entry

Resistance exercise does not have to rely on expensive equipment; bodyweight movements (such as push-ups and squats) or resistance-band training can be effective. Setting up simple, doable training programs is especially important for beginners.

• Overcome gender and age barriers

Older adults and women often avoid resistance exercise because of a lack of confidence or knowledge. Group classes or dedicated programs designed for these groups can help lower psychological barriers.

Closing thoughts

Resistance exercise has evolved from the exclusive domain of traditional strength training into one of the core strategies for promoting health. Complementing aerobic exercise, it can improve physical fitness while also slowing aging and lowering the risk of chronic disease. Fitness professionals and public-health advocates should work to promote resistance exercise so that more people can enjoy its wide-ranging health benefits.

References

ACSM’s Health & Fitness Journal 27(6):p 19-25, 11/12 2023.