The combination of aerobic and resistance training (AER + RES) is recommended by almost every major organization to improve health-related risk factors associated with sedentary behavior. Since the release of the Physical Activity Guidelines for Americans in 2008, several large well-controlled trials and ancillary reports have been published that provide further insight into the effects of AER + RES on health-related outcomes. The current manuscript examines the literature on the effects of AER + RES on major clinical outcomes, including glucose homeostasis, cardiorespiratory fitness (CRF), and muscular strength, as well as other important clinical outcomes, including metabolic syndrome, hypertension, dyslipidemia, and quality of life. Collectively, research suggests that AER + RES and AER or RES alone improves glycemic control and insulin sensitivity compared with continued sedentary behavior. Significant changes in CRF are also observed, suggesting a reduction in cardiovascular disease-related mortality risk. Reduced adiposity, especially abdominal adiposity, and increased strength may also interact with CRF to promote additional health benefits associated with AER + RES. While findings from our review support current physical activity guidelines, a paucity of research limits the generalizability of the results.
Sedentary Behavior Functional Fitness Moderate Dyslipidemia Dare Study Ancillary Report
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Neil Johannsen, Timothy Church, Damon Swift, Carl Lavie, Steven Blair and Conrad Earnest contributed to the review’s concept and design, drafted the manuscript, contributed critical revisions of the manuscript for important intellectual content, and reviewed and approved the final version of the manuscript.
Compliance with Ethical Standards
No sources of funding were used to assist in the preparation of this article.
Conflict of Interest
Neil Johannsen, Damon Swift, Carl Lavie, Conrad Earnest, Steven Blair and Timothy Church declare that they have no conflicts of interest relevant to the content of this review.
Albright A, Franz M, Hornsby G, et al. American College of Sports Medicine position stand. Exercise and type 2 diabetes. Med Sci Sports Exerc. 2000;32(7):1345–60.CrossRefPubMedGoogle Scholar
Haskell WL, Lee I-M, Pate RR, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007;39(8):1423–34.CrossRefPubMedGoogle Scholar
Garber CE, Blissmer B, Deschenes MR, et al. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43(7):1334–59.CrossRefPubMedGoogle Scholar
Boule NG, Haddad E, Kenny GP, et al. Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta-analysis of controlled clinical trials. JAMA. 2001;286(10):1218–27.CrossRefPubMedGoogle Scholar
Vuori IM, Lavie CJ, Blair SN. Physical activity promotion in the health care system. Mayo Clin Proc. 2013;88(12):1446–61.CrossRefPubMedGoogle Scholar
Centers for Disease Control and Prevention. National diabetes statistics report: estimates of diabetes and its burden in the United States, 2014. Atlanta: U.S. Department of Health and Human Services, CDC; 2014.Google Scholar
US Centers for Disease Control and Prevention. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta: US Department of Health and Human Services, CDC; 2011.Google Scholar
Donnelly JE, Blair SN, Jakicic JM, et al. American College of Sports Medicine position stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc. 2009;41(2):459–71. doi:10.1249/MSS.0b013e3181949333.CrossRefPubMedGoogle Scholar
Sigal RJ, Kenny GP, Boule NG, et al. Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial. Ann Intern Med. 2007;147(6):357–69.CrossRefPubMedGoogle Scholar
Balducci S, Zanuso S, Nicolucci A, et al. Effect of an intensive exercise intervention strategy on modifiable cardiovascular risk factors in subjects with type 2 diabetes mellitus: a randomized controlled trial: the Italian Diabetes and Exercise Study (IDES). Arch Intern Med. 2010;170(20):1794–803. doi:10.1001/archinternmed.2010.380.CrossRefPubMedGoogle Scholar
AbouAssi H, Slentz CA, Mikus CR, et al. The effects of aerobic, resistance, and combination training on insulin sensitivity and secretion in overweight adults from STRRIDE AT/RT: a randomized trial. J Appl Physiol (1985). 2015;118(12):1474–82. doi:10.1152/japplphysiol.00509.2014.CrossRefGoogle Scholar
Cuff DJ, Meneilly GS, Martin A, et al. Effective exercise modality to reduce insulin resistance in women with type 2 diabetes. Diabetes Care. 2003;26(11):2977–82.CrossRefPubMedGoogle Scholar
Shulman GI, Rothman DL, Jue T, et al. Quantitation of muscle glycogen synthesis in normal subjects and subjects with non-insulin-dependent diabetes by 13C nuclear magnetic resonance spectroscopy. N Engl J Med. 1990;322(4):223–8. doi:10.1056/NEJM199001253220403.CrossRefPubMedGoogle Scholar
Hickson RC. Interference of strength development by simultaneously training for strength and endurance. Eur J Appl Physiol Occ Physiol. 1980;45(2–3):255–63.CrossRefGoogle Scholar
Blair SN, Kohl HW 3rd, Paffenbarger RS Jr, et al. Physical fitness and all-cause mortality. A prospective study of healthy men and women. JAMA. 1989;262(17):2395–401.CrossRefPubMedGoogle Scholar
Swift DL, Lavie CJ, Johannsen NM, et al. Physical activity, cardiorespiratory fitness, and exercise training in primary and secondary coronary prevention. Circ J. 2013;77(2):281–92.CrossRefPubMedGoogle Scholar
Kodama S, Saito K, Tanaka S, et al. Cardiorespiratory fitness as a quantitative predictor of all-cause mortality and cardiovascular events in healthy men and women. JAMA. 2009;301(19):2024–35. doi:10.1001/jama.2009.681.CrossRefPubMedGoogle Scholar
Johannsen NM, Swift DL, Lavie CJ, et al. Categorical analysis of the impact of aerobic and resistance exercise training, alone and in combination, on cardiorespiratory fitness levels in patients with type 2 diabetes mellitus: results from the HART-D study. Diabetes Care. 2013;36(10):3305–12. doi:10.2337/dc12-2194.CrossRefPubMedPubMedCentralGoogle Scholar
Morris CK, Myers J, Froelicher VF, et al. Nomogram based on metabolic equivalents and age for assessing aerobic exercise capacity in men. J Am Coll Cardiol. 1993;22(1):175–82.CrossRefPubMedGoogle Scholar
Ross R, Hudson R, Stotz PJ, et al. Effects of exercise amount and intensity on abdominal obesity and glucose tolerance in obese adults: a randomized trial. Ann Intern Med. 2015;162(5):325–34. doi:10.7326/M14-1189.CrossRefPubMedGoogle Scholar
Wolfe RR. The underappreciated role of muscle in health and disease. Am J Clin Nutr. 2006;84(3):475–82.PubMedGoogle Scholar
Fujita Y, Nakamura Y, Hiraoka J, et al. Physical-strength tests and mortality among visitors to health-promotion centers in Japan. J Clin Epidemiol. 1995;48(11):1349–59.CrossRefPubMedGoogle Scholar
Rantanen T, Harris T, Leveille SG, et al. Muscle strength and body mass index as long-term predictors of mortality in initially healthy men. J Gerontol A Biol Sci Med Sci. 2000;55(3):M168–73.CrossRefPubMedGoogle Scholar
Newman AB, Kupelian V, Visser M, et al. Strength, but not muscle mass, is associated with mortality in the health, aging and body composition study cohort. J Gerontol A Biol Sci Med Sci. 2006;61(1):72–7.CrossRefPubMedGoogle Scholar
Wood RH, Reyes R, Welsch MA, et al. Concurrent cardiovascular and resistance training in healthy older adults. Med Sci Sports Exerc. 2001;33(10):1751–8.CrossRefPubMedGoogle Scholar
Senechal M, Swift DL, Johannsen NM, et al. Changes in body fat distribution and fitness are associated with changes in hemoglobin A1c after 9 months of exercise training: results from the HART-D study. Diabetes Care. 2013;36(9):2843–9. doi:10.2337/dc12-2428.CrossRefPubMedPubMedCentralGoogle Scholar
Reid RD, Tulloch HE, Sigal RJ, et al. Effects of aerobic exercise, resistance exercise or both, on patient-reported health status and well-being in type 2 diabetes mellitus: a randomised trial. Diabetologia. 2010;53(4):632–40. doi:10.1007/s00125-009-1631-1.CrossRefPubMedGoogle Scholar