title: A higher effort-based paradigm in physical activity and exercise for public health: making the case for a greater emphasis on resistance training.
abstract: It is well known that physical activity and exercise is associated with a lower risk of a range of morbidities and all-cause mortality. Further, it appears that risk reductions are greater when physical activity and/or exercise is performed at a higher intensity of effort. Why this may be the case is perhaps explained by the accumulating evidence linking physical fitness and performance outcomes (e.g. cardiorespiratory fitness, strength, and muscle mass) also to morbidity and mortality risk. Current guidelines about the performance of moderate/vigorous physical activity using aerobic exercise modes focuses upon the accumulation of a minimum volume of physical activity and/or exercise, and have thus far produced disappointing outcomes. As such there has been increased interest in the use of higher effort physical activity and exercise as being potentially more efficacious. Though there is currently debate as to the effectiveness of public health prescription based around higher effort physical activity and exercise, most discussion around this has focused upon modes considered to be traditionally 'aerobic' (e.g. running, cycling, rowing, swimming etc.). A mode customarily performed to a relatively high intensity of effort that we believe has been overlooked is resistance training. Current guidelines do include recommendations to engage in 'muscle strengthening activities' though there has been very little emphasis upon these modes in either research or public health effort. As such the purpose of this debate article is to discuss the emerging higher effort paradigm in physical activity and exercise for public health and to make a case for why there should be a greater emphasis placed upon resistance training as a mode in this paradigm shift.
authors.affiliation: School of Sport, Health, and Social Science, Southampton Solent University, Southampton, SO14 0YN, UK. james.steele@solent.ac.uk.
authors.forename: James
authors.identifier: 0000-0002-8003-0757
authors.initials: J
authors.lastname: Steele
authors.affiliation: School of Sport, Health, and Social Science, Southampton Solent University, Southampton, SO14 0YN, UK.
authors.forename: James
authors.initials: J
authors.lastname: Fisher
authors.affiliation: School of Sport, Health, and Social Science, Southampton Solent University, Southampton, SO14 0YN, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: Skivington
authors.affiliation: School of Sport, Health, and Social Science, Southampton Solent University, Southampton, SO14 0YN, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Dunn
authors.affiliation: School of Sport, Health, and Social Science, Southampton Solent University, Southampton, SO14 0YN, UK.
authors.forename: Josh
authors.initials: J
authors.lastname: Arnold
authors.affiliation: Exercise and Health Sciences Department: Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, NE1 8ST, UK.
authors.forename: Garry
authors.initials: G
authors.lastname: Tew
authors.affiliation: School of Health and Social Care, Teesside University, Middleborough, TS1 3BA, UK.
authors.forename: Alan M
authors.initials: AM
authors.lastname: Batterham
authors.affiliation: Centre for Evidence-Based Medicine, Nuffield Department of Primary |Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK.
authors.forename: David
authors.initials: D
authors.lastname: Nunan
authors.affiliation: School of Human and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK.
authors.forename: Jamie M
authors.initials: JM
authors.lastname: O'Driscoll
authors.affiliation: UK Active Research Institute, UK Active, London, WC1R 4HE, UK.
authors.forename: Steven
authors.initials: S
authors.lastname: Mann
authors.affiliation: School of Human and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK.|UK Active Research Institute, UK Active, London, WC1R 4HE, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Beedie
authors.affiliation: Department of Sport & Exercise, University of Winchester, Winchester, SO22 4NR, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Jobson
authors.affiliation: Department of Exercise and Sport Science, Manchester Metropolitan University, Crewe, CW1 5DU, UK.
authors.forename: Dave
authors.initials: D
authors.lastname: Smith
authors.affiliation: Department of Biomedical Engineering, Northwestern University, Evanston, IL, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Vigotsky
authors.affiliation: Department of Kinesiology, McMaster University, Hamilton, ON, Canada.
authors.forename: Stuart
authors.initials: S
authors.lastname: Phillips
authors.affiliation: College of Public Health, University of Nebraska Medical Centre, Omaha, NE, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Estabrooks
authors.affiliation: Psychology Department, Virginia Tech, Blacksburg, VA, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Winett
mesh_terms: D006301:Health Services Needs and Demand; D006801:Humans; D009765:Obesity / Q000517:prevention & control*; D011634:Public Health; D055070:Resistance Training; D013222:State Medicine; D006113:United Kingdom
keywords: Cardiorespiratory; Exercise; Fitness; Morbidity; Mortality; Muscle; Physical activity; Public health; Strength