A higher effort-based paradigm in physical activity and exercise for public health: making the case for a greater emphasis on resistance training

Abstract

It is well known that physical activity and exercise is associated with a lower risk of a range of morbidities and all-cause mortality. Further, it appears that risk reductions are greater when physical activity and/or exercise is performed at a higher intensity of effort. Why this may be the case is perhaps explained by the accumulating evidence linking physical fitness and performance outcomes (e.g. cardiorespiratory fitness, strength, and muscle mass) also to morbidity and mortality risk. Current guidelines about the performance of moderate/vigorous physical activity using aerobic exercise modes focuses upon the accumulation of a minimum volume of physical activity and/or exercise, and have thus far produced disappointing outcomes. As such there has been increased interest in the use of higher effort physical activity and exercise as being potentially more efficacious. Though there is currently debate as to the effectiveness of public health prescription based around higher effort physical activity and exercise, most discussion around this has focused upon modes considered to be traditionally ‘aerobic’ (e.g. running, cycling, rowing, swimming etc.). A mode customarily performed to a relatively high intensity of effort that we believe has been overlooked is resistance training. Current guidelines do include recommendations to engage in ‘muscle strengthening activities’ though there has been very little emphasis upon these modes in either research or public health effort. As such the purpose of this debate article is to discuss the emerging higher effort paradigm in physical activity and exercise for public health and to make a case for why there should be a greater emphasis placed upon resistance training as a mode in this paradigm shift.

Participation in moderate-to-vigorous leisure time physical activity is related to decreased visceral adipose tissue in adults with spinal cord injury

“…Relatedly, the impact of voluntary resistance training on VAT, and other health outcomes, in the SCI population remains understudied. While the tendency is to focus on aerobic exercise training in the field of exercise physiology and public health (Steele et al, 2017), resistance training has observed, and possibly equal, benefits to aerobic training on risk of multimorbidity in the ablebodied population (Dankel et al, 2015;Phillips & Winett, 2010). The tools used for this assessment collected overall LTPA, primarily validated for aerobic activity, and we are unable to make any conclusions related to type of LTPA.…”

Efficacy of School-Based Interventions for Improving Muscular Fitness Outcomes in Adolescent Boys: A Systematic Review and Meta-analysis

“…Future research should utilise TEO to allow both teachers and students to become familiar with the prescription of RT through the addition of its use within a school-based setting. This may help dispel some of the myths surrounding implementation (i.e., the need for specialist equipment and RT can damage growth) [112] and cultivate future intervention design.…”

Exploring the differentiated relationship between appearance and fitness‐related social anxiety and the risk of eating disorders and depression in young adults

“…These results reinforce the notion that not only a poor body appearance (Voelker et al ., ) but also a poor fitness level could be perceived as a feature that is subject to social sanction (Carter et al ., ). One of the reasons behind such perceptions may be found in public health messages aimed at promoting exercise and physical fitness (Garber, Blissmer, Deschenes et al ., ; Steele, Fisher, Skivington et al ., ). Indeed, some scholars have warned about the potential dangers of public health messages that, adopting a neoliberal and achievement‐oriented perspective, place all the responsibility with respect to fitness and health promotion on the individual (Cairney, McGannon & Atkinson, ; Carter et al ., ).…”