Trends in adherence to the muscle-strengthening activity guidelines in the US over a 20-year span.
Level 4 - case-series / case-control
Repeated cross-sectional survey analysis without individual longitudinal follow-up
PubMed 37413717 · doi:10.1016/j.genhosppsych.2023.06.016
What was done
Analyzed pooled data from 22 consecutive annual cycles (1997 to 2018) of the National Health Interview Survey (NHIS), a nationally representative cross-sectional household interview survey in the United States. Evaluated temporal trends and prevalence of adherence to muscle-strengthening activity (MSA) guidelines across adult age brackets (18–24, 25–34, 35–44, 45–64, and ≥65 years).
What was found
Across 651,682 participants (mean age 47.7 years, 55.8% women), overall adherence to MSA guidelines increased significantly from 19.8% in 1997 to 27.2% in 2018 (p < .001). Adherence increased significantly across all age groups (p < .001). Compared to non-Hispanic white females, Hispanic females had lower odds of adherence (odds ratio 0.5, 95% CI 0.4–0.6).
Why it matters
While muscle-strengthening activity participation grew over two decades in the US, fewer than 30% of adults met recommended guidelines prior to the COVID-19 pandemic, with persistent demographic disparities.
Limits
Relies on self-reported activity data subject to recall and social desirability biases. As a series of cross-sectional surveys, it cannot track individual behavior trajectories over time. The dataset terminates in 2018 and does not reflect post-2018 or COVID-19 pandemic changes.
Cited by
- supports Approximately 80% to 90% of the United States population fails to meet standard resistance training guidelines.