Run, lift, or both? Associations between concurrent aerobic–muscle strengthening exercise with adverse cardiometabolic biomarkers among Korean adults

Background: Clinical exercise interventions show that combining moderate to vigorous intensity physical activity (MVPA) and muscle strengthening exercise (MSE) has more favourable cardiometabolic health benefits than engaging in only one mode of physical activity. However, few studies have examined these associations among community-based samples and none among Asian adults. Methods: This cross-sectional analysis included 9120 participants aged 20–80 years from the 2014–2015 Korea National Health and Nutritional Examination Survey. Fasting blood samples were analysed for adverse cardiometabolic biomarkers (e.g. high glucose/glycohaemoglobin/triglycerides) and MVPA and MSE were assessed using validated questionnaires. Poisson regression models examined the association between the individual and total number of adverse biomarkers across categories of MVPA–MSE guideline adherence (met neither (reference); met MSE only; met MVPA only; met both) and prevalence ratios are reported adjusted for covariates (e.g. age, education, smoking, waist circumference and sitting time). Results: The mean ± SD age was 46.2 ± 16.3 years and 50.3% of the participants were women. Compared with meeting neither guideline, meeting both guidelines had the lowest prevalence ratios for four out of eight individual adverse cardiometabolic biomarkers. In a sex-stratified analysis of men, only meeting both guidelines had a lower prevalence ratio for ≥4 adverse biomarkers (prevalence ratio 0.67; 95% confidence interval 0.53–0.85). For women, the prevalence ratio for ≥4 adverse biomarkers was lowest among those meeting both guidelines (prevalence ratio 0.46; 95% confidence interval 0.31–0.66), followed by MSE only (prevalence ratio 0.65; 95% confidence interval 0.42–0.96) and MVPA only (prevalence ratio 0.78; 95% confidence interval 0.65–0.92). Conclusions: Among a large sample of Korean adults, concurrent MVPA–MSE was independently associated with favourable cardiometabolic outcomes. This study supports public health action to promote adherence to MVPA–MSE guidelines to enhance cardiovascular health among Korean adults