Why You Should be Doing Endurance and Resistance Training for Health and Longevity

Everyone knows exercise is good for us. It promotes metabolic health, cardiovascular health, cognitive function, muscle, tendon, and bone health, immune function, and a whole host of other things. Engaging in physical activity can help maintain a healthy weight, reduce the risk of chronic diseases such as heart disease, diabetes, and stroke, improve overall cardiovascular health, and reduce the risk of injury. Regular physical activity has been linked to increased longevity because of these beneficial effects on all the different organ systems in the body. But there are different types of exercise to choose from when it comes time to execute a training plan. So, the question is what type of exercise SHOULD you do to achieve these benefits?

It is often the assumption that endurance type exercise is the key to unlocking these health benefits mentioned above. Historically beneficial effects of resistance training have been largely ignored. However resistance exercise is increasingly recognized to have beneficial health effects independently of endurance exercise. When comparing endurance training and resistance training, it's important to recognize their distinct benefits and effects on the body. Endurance training improves cardiovascular health, reduces task fatigue, and improves metabolic health, while resistance training improvements occur more in the domains of muscle strength, power, and mobility. These differences really come down to how your body uses or “recruits” your muscles to perform each type of exercise. Endurance exercise primarily recruits slow-twitch muscle fibers and those slow twitch fibers have a varied, yet cyclical activation pattern over a long(er) time period. Resistance exercise recruits both fast-twitch and slow twitch muscle fibers to perform the exercise, rather than primarily only slow twitch fibers with endurance training. The recruitment pattern is also very different - the muscles are activated more completely over a wider range of motion for fewer repetitions, but each contraction lasts much longer. Because of these different recruitment demands placed on the muscles by endurance or resistance exercise, there are different second order effects on whole body metabolism, the type and magnitude of stress each internal organ system “feels”, and is responsible for some of the variation in how your body adapts to each type of training.

Figure adapted from Brellenthin et al., 2022.

The Venn Diagram above compares endurance and resistance training head to head using a battery of physiological metrics. There are unique physiological effects of each modality. One type is good for promoting one set of physiological outcomes, another type is good for promoting a different set of outcomes. But the MOST interesting piece is that when you compare people who do either resistance training or endurance training with people who do BOTH resistance and endurance training, the people who do combined resistance and endurance have better outcomes than either alone. This is demonstrated by a reduction in Hazard Ratio (HR) compared to a sedentary control group (black bars) for each cause specific mortality below.

Figure adapted from Brellenthin et al., 2022. Reductions in the Hazard Ratio of All-cause and cause-specific mortality by group. Black bars are sedentary controls (HR=1) green bars= muscle strengthening only, blue bars = endurance exercise only, and pink bars = combined endurance and resistance trained individuals.

The graph clearly shows a reduction in all-cause and cause-specific mortality for both resistance and endurance type training (green and blue bars respectively). In every case the mortality risk declines even more when looking at combined training in the pink bars (this = better health!).

What does this mean for you?

If your goal is to maximize overall health and have a balanced and well-rounded health profile, then you should absolutely be doing a combined program that includes both resistance and endurance training modalities.

How do you execute a combined program safely and effectively?

The American College of Sports Medicine recommends 150 minutes per week of moderate intensity physical activity (endurance training) and at least 2 days per week of moderate intensity muscle strengthening (resistance) training. This should include all major muscle groups of the lower and upper body. This is a challenging ask for many people and probably explains why less than 20% of the American population meets these guidelines.

I will discuss effective strategies on how to do this in future posts, but for now good luck!