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Muscle-strengthening activities to improve health outcomes: what the evidence supports
  1. Katherine Rose Marino1,
  2. Dane Vishnubala2,3,
  3. Pekka Oja4
  1. 1 Royal Stoke University Hospital, Stoke-on-Trent, UK
  2. 2 Hull York Medical School, Hull, UK
  3. 3 University of Leeds, Leeds, UK
  4. 4 UKK Institute for Health Promotion Research, Tampere, Finland
  1. Correspondence to Dr Katherine Rose Marino, Royal Stoke University Hospital, Stoke-on-Trent ST4 6QG, UK; katiemarino{at}

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Evidence for the benefits of regular physical activity is irrefutable. Physical activity guidelines often include a mix of aerobic and muscle-strengthening activities. Muscle strengthening activities can also be referred to as strength, weights or resistance exercise and are defined as a voluntary activity that includes the use of weight machines, exercise bands, hand-held weights or own-body weight.1 Recent data suggest that only 10%–30% of adults meet the muscle-strengthening activity recommendations.2–5 While focus has previously been placed on musculoskeletal benefits, research has also found muscle-strengthening activities are independently associated with a variety of improved health outcomes including decreases in all-cause mortality, and improvements in cardiometabolic and mental health.6

Historic lack of emphasis on muscle-strengthening activities

While physical activity recommendations that include aerobic activity have been available since the 1970s, muscle-strengthening activities were first included in the WHO’s physical activity recommendations in 2010.7 The inclusion of muscle-strengthening activities was further highlighted in the 2020 WHO physical activity recommendations which state that adults should do muscle-strengthening activities at moderate or greater intensity …

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  • Contributors KRM wrote the initial draft of the text. All authors reviewed and edited the text and approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests KRM is an associate editor of the BJSM.

  • Provenance and peer review Not commissioned; externally peer reviewed.