The association of resistance training with mortality: A systematic review and meta-analysis

Abstract

Background The benefits of aerobic exercise are well-studied; there is no consensus on the association between resistance training and major adverse cardiovascular outcomes. This systematic review and meta-analysis aimed to address this issue. Design and methods We searched for randomized trials and cohort studies that evaluated the association between resistance training and mortality and cardiovascular events. Two investigators screened the identified abstracts and full-texts independently and in duplicate. Cochrane tools were used to assess the risk of bias. We calculated hazard ratios and 95% confidence intervals using random effect models. Results From the 1430 studies identified, 11 (one randomized trial and 10 cohort studies) met the inclusion criteria, totaling 370,256 participants with mean follow-up of 8.85 years. The meta-analysis showed that, compared with no exercise, resistance training was associated with 21% (hazard ratio (95% confidence interval (CI)), 0.79 (0.69–0.91)) and 40% (hazard ratio (95% CI), 0.60 (0.49–0.72)) lower all-cause mortality alone and when combined with aerobic exercise, respectively. Furthermore, resistance training had a borderline association with lower cardiovascular mortality (hazard ratio (95% CI), 0.83 (0.67–1.03)). In addition, resistance training showed no significant association with cancer mortality. Risk of bias was low to intermediate in the included studies. One cohort study looked at the effect of resistance training on coronary heart disease events in men and found a 23% risk reduction (risk ratio, 0.77, CI: 0.61–0.98). Conclusion Resistance training is associated with lower mortality and appears to have an additive effect when combined with aerobic exercise. There are insufficient data to determine the potential beneficial effect of resistance training on non-fatal events or the effect of substituting aerobic exercise with resistance training.

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

“…Strong clinical and emerging epidemiological evidence shows that muscle-strengthening exercise (i.e. use of weight machines/body weight exercises) is independently associated with multiple health outcomes, including a reduced risk of all-cause mortality [1][2][3], incidence of diabetes [4,5] and enhanced cardiometabolic [6,7], musculoskeletal [8][9][10] and mental health [11,12]. However, recent health surveillance data from multiple countries suggest only 10-30% adults meet the musclestrengthening exercise guideline (≥ 2 sessions/week) [13][14][15][16][17][18].…”

Joint and dose‐dependent associations between aerobic and muscle‐strengthening activity with depression: A cross‐sectional study of 1.48 million adults between 2011 and 2017

“…This MSA item has acceptable test-retest reliability (Cohen's κ = 0.85, 95% CI: 0.71-0.99; Yore et al, 2007), and convergent validity (against all-cause mortality; Saeidifard et al, 2019).…”

“…This MSA item has acceptable test-retest reliability (Cohen's κ = 0.85, 95% CI: 0.71-0.99; Yore et al, 2007), and convergent validity (against all-cause mortality; Saeidifard et al, 2019). MVPA was evaluated by asking "During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?".…”

Editor’s presentation: ‘You say you love your children above all else, and yet you are stealing their future in front of their very eyes’

“…Saeidifard and colleagues have performed a meta-analysis of mortality studies comparing strength exercise with aerobic or no exercise in mixed cohorts on the general adult population, that is, healthy persons and cardiovascular as well as cancer patients. 12 A reduction of all-cause mortality of 21% with resistance training alone and of 40% when combined with aerobic exercise, when compared with no exercise were reported. Notably, 370,256 participants with a mean follow-up of 8.85 years were included, with different characteristics, which points to major limitations, that is, the role of many possible unmeasured confounders as well as the danger of inclusion bias, as acknowledged by the authors themselves.…”