The relationship between resistance exercise and cardiometabolic health: a cross-sectional analysis of the 1970 British cohort study

Abstract Purpose Resistance exercise (RE) has been shown to have a positive impact on cardiometabolic health, independent of moderate-vigorous physical activity (MVPA). However, previous studies primarily used self-reported MVPA data, which are prone to bias. The aim of this study was to examine if the association between RE frequency and cardiometabolic health was independent of device-measured MVPA. Methods Cross-sectional analyses were conducted using participants from the 1970 British Cohort Study. This included up to 4,881 participants (age 46–48) with outcome-specific analytical samples. RE frequency data were collected via self-report. MVPA data were collected via thigh-worn accelerometry. Cardiometabolic outcomes included systolic blood pressure (SBP), total cholesterol:high-density lipoprotein cholesterol (TC:HDL-C) ratio, and HbA1c. Associations between RE frequency and each outcome were tested using multivariable linear regression and presented as percent differences. Covariates included sex, MVPA, smoking status, alcohol consumption, educational attainment, self-rated health, and disability. Results Compared to ‘no RE’, RE frequency was inversely associated with SBP (percent difference [95% CI]; 2–4 times/month: −1.28% [−2.38, −0.19]; ≥ 2 times/week: −1.12% [−2.11, −0.14]), TC:HDL-C (2–4 times/month: −5.00% [−8.19, −1.81]; ≥ 2 times/week: −7.04% [−9.89, −4.19]), and HbA1c (2–4 times/month: -3.04% [−4.76,−1.32]; ≥ 2 times/week: -3.03% [−4.56,−1.50]) in models adjusted for sex and MVPA. These associations were attenuated after adjusting for all covariates, except for an inverse association between RE frequency ≥ 2 times/week and TC:HDL-C (−3.99% [−6.83,−1.15]). Conclusion We identified consistent inverse associations between RE frequency and cardiometabolic outcomes. Associations were largely maintained after adjustment for sex and device-measured MVPA, but were mostly attenuated after additional adjustment for behavioral and health-related covariates. Only TC:HDL-C remained independently associated with high-frequency RE, suggesting that regular RE may be associated with a more favorable TC:HDL-C profile independent of MVPA.