Aerobic exercise continues to be the prevailing mode of exercise endorsed for physical fitness and health. Current public health recommendations place a clear emphasis on aerobic activities.^1–3 The U.S. Surgeon General, the Centers for Disease Control and Prevention, and the American College of Sports Medicine (ACSM) all espouse encouraging the accumulation of 30 minutes of aerobic activity most days of the week.

Strength, or resistance, training has not enjoyed the same degree of popularity as aerobic exercise.⁴ Strength training has continually suffered from its antiquated image as an odd, frivolous activity associated with dank gyms, Eastern bloc weightlifters, or narcissistic bodybuilders. Both the medical and exercise science communities long believed that strength training offered little in the way of health benefits, or worse still, considered it to be a detriment to good health.^5,6 It was not until 1990 that the ACSM included resistance exercise in its recommendations for achieving physical fitness.⁷

There is now a substantial and ever-growing body of evidence demonstrating the merits of strength training. When combined with aerobic exercise, some of the benefits are additive, whereas others are unique to strength training and cannot be achieved through aerobic activity alone. Many of these benefits may be particularly useful when employed in the management of chronic diseases such as diabetes. Health care providers, however, often remain unfamiliar, unconvinced, or both regarding recommendations for strength training exercise for their patients.

Strength Training, Fitness, and Function

Physical fitness is composed of several components, including cardiorespiratory endurance, body composition, muscular endurance, muscular strength or power, flexibility, and balance/coordination. Each component of fitness has a unique role in the preservation of health. Whereas aerobic exercise primarily targets the cardiorespiratory endurance component, strength training appears to play a prominent role in many, if not all, of the other six components …