Association of Resistance Exercise, Independent of and Combined With Aerobic Exercise, With the Incidence of Metabolic Syndrome

Abstract

Objective: To determine the association of resistance exercise, independent of and combined with aerobic exercise, with the risk of development of metabolic syndrome (MetS).

Patients and methods: The study cohort included adults (mean ± SD age, 46±9.5 years) who received comprehensive medical examinations at the Cooper Clinic in Dallas, Texas, between January 1, 1987, and December, 31, 2006. Exercise was assessed by self-reported frequency and minutes per week of resistance and aerobic exercise and meeting the US Physical Activity Guidelines (resistance exercise ≥2 d/wk; aerobic exercise ≥500 metabolic equivalent min/wk) at baseline. The incidence of MetS was based on the National Cholesterol Education Program Adult Treatment Panel III criteria. We used Cox regression to generate hazard ratios (HRs) and 95% CIs.

Results: Among 7418 participants, 1147 (15%) had development of MetS during a median follow-up of 4 years (maximum, 19 years; minimum, 0.1 year). Meeting the resistance exercise guidelines was associated with a 17% lower risk of MetS (HR, 0.83; 95% CI, 0.73-0.96; P=.009) after adjusting for potential confounders and aerobic exercise. Further, less than 1 hour of weekly resistance exercise was associated with 29% lower risk of development of MetS (HR, 0.71; 95% CI, 0.56-0.89; P=.003) compared with no resistance exercise. However, larger amounts of resistance exercise did not provide further benefits. Individuals meeting both recommended resistance and aerobic exercise guidelines had a 25% lower risk of development of MetS (HR, 0.75; 95% CI, 0.63-0.89; P<.001) compared with meeting neither guideline.

Conclusion: Participating in resistance exercise, even less than 1 hour per week, was associated with a lower risk of development of MetS, independent of aerobic exercise. Health professionals should recommend that patients perform resistance exercise along with aerobic exercise to reduce MetS.

Figure 1

Hazard ratios of metabolic syndrome by the combination of weekly frequency (1–2 vs ≥3 times/week) and minutes of resistance exercise (0, 1–59, 60–119, 120–179 and ≥180 min/week). The dots indicate hazard ratios and the lines present 95% confidence intervals. The model was adjusted for age (years), gender, examination year (year), body mass index (kg/m²), current smoking (yes/no), heavy alcohol drinking (yes/no), abnormal electrocardiography (yes/no), parental history of cardiovascular, hypertension, diabetes (yes/no for each), and aerobic exercise (inactive, insufficient, medium and high). Analysis in the category of ≥180 minutes in 1–2 sessions resistance exercise per week was not applicable (NA).

Figure 2

Hazard ratios of metabolic syndrome by meeting the 2008 US Physical Activity Guidelines for resistance (≥2 days/week) and aerobic activities (≥500 MET-minutes/week) at baseline. The bars present hazard ratios (95% confidence intervals). The model was adjusted for age (years), gender, examination year (year), body mass index (kg/m²), current smoking (yes/no), heavy alcohol drinking (yes/no), abnormal electrocardiography (yes/no), and parental history of cardiovascular disease, hypertension and diabetes (yes/no for each).