Association of meeting both muscle strengthening and aerobic exercise guidelines with prevalent overweight and obesity classes - results from a nationally representative sample of German adults.

Objectives: German national physical activity guidelines specify adults (≥18 years) should engage in at least: (i) 150 min of aerobic moderate-to-vigorous-intensity physical activity/week (MVPA); and (ii) muscle-strengthening exercise (MSE) 2 days/week. However, the relationship between MVPA and MSE and overweight/obesity has not been examined among German adults. Aim of this study was to examine whether meeting the guidelines for both MVPA and MSE is associated with a lower prevalence of overweight/obesity compared to meeting MVPA or MSE alone or none of them, among a nationally representative sample of German adults.
Methods: The cross-sectional study drew data from the 2014 German Health Update (GEDA) (n=22,822; ≥18 years). Physical activity (MVPA-MSE), height/weight, socio-demographic, health and lifestyle factors were assessed by self-report via validated questionnaires. Generalized linear models with Poisson regression were used to assess prevalence ratios of Body Mass Index-derived (BMI) overweight/obesity across categories of physical activity guideline adherence (met neither; MSE only; MVPA only; met both).
Results: Compared to other physical activity groups, meeting both the MVPA-MSE guidelines was associated with the lowest prevalence rate of overweight/obesity (Adjusted Prevalence Ratios [APR] range: 0.25-0.73). Associations between BMI and physical activity were strongest among Class II obesity (APR range: 0.25-0.45). The associations remained consistent after adjusting sociodemographic and lifestyle factors.
Conclusions: Meeting the combined MVPA-MSE guideline, as suggested in the German national physical activity recommendations, showed the lowest overweight/obesity prevalence. Promoting uptake and adherence of both MVPA and MSE at the population level could help to reduce the public health burden of obesity. Highlights Meeting both muscle strengthening and aerobic exercise guidelines show the lowest overweight/obesity prevalence in a German representative sample of adults. Promoting uptake and adherence of both MVPA and MSE at the population level could help to reduce the public health burden of obesity.