Objective: To quantify the associations between muscle-strengthening activities and risk of noncommunicable diseases and mortality in adults independent of aerobic activities.
Design: Systematic review and meta-analysis of prospective cohort studies.
Data sources: MEDLINE and Embase were searched from inception to June 2021, and the reference lists of all related articles were reviewed.
Eligibility criteria for selecting studies: Prospective cohort studies that examined the association between muscle-strengthening activities and health outcomes in adults aged ≥ 18 years without severe health conditions.
Results: Sixteen studies met the eligibility criteria. Muscle-strengthening activities were associated with a 10−17% lower risk of all-cause mortality, cardiovascular disease, total cancer, diabetes, and lung cancer. No association was found between muscle-strengthening activities and the risk of some site-specific cancers (colon, kidney, bladder, and pancreatic cancers). J-shaped associations with the maximum risk reduction (approximately 10−20%) at approximately 30−60 min/week of muscle-strengthening activities were found for all-cause mortality, CVD, and total cancer, whereas an L-shaped association showing a large risk reduction at up to 60 min/week of muscle-strengthening activities was observed for diabetes. Combined muscle-strengthening and aerobic activities (vs. none) were associated with a lower risk of all-cause, CVD, and total cancer mortality.
Conclusion: Muscle-strengthening activities were inversely associated with the risk of all-cause mortality and major non-communicable diseases including CVD, total cancer, diabetes, and lung cancer; however, the influence of a higher volume of muscle-strengthening activities on all-cause mortality, CVD, and total cancer is unclear when considering the observed J-shaped associations.
Systematic review registration: PROSPERO CRD42020219808
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