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Women may realize health benefits of regular exercise more than men

Two women laugh and talk while power walking.

An NIH-supported observational study finds that even when women and men get the same amount of physical activity, the risk of premature death is lower for women

Women who exercise regularly have a significantly lower risk of an early death or fatal cardiovascular event than men who exercise regularly, even when women put in less effort, according to a National Institutes of Health-supported study. The findings, published in the  Journal of the American College of Cardiology , are based on a prospective analysis of data from more than 400,000 U.S. adults ages 27-61 which showed that over two decades, women were 24% less likely than those who do not exercise to experience death from any cause, while men were 15% less likely. Women also had a 36% reduced risk for a fatal heart attack, stroke, or other cardiovascular event, while men had a 14% reduced risk.   

“We hope this study will help everyone, especially women, understand they are poised to gain tremendous benefits from exercise,” said Susan Cheng, M.D., a cardiologist and the Erika J. Glazer Chair in Women’s Cardiovascular Health and Population Science in the Smidt Heart Institute at Cedars-Sinai, Los Angeles. “It is an incredibly powerful way to live healthier and longer. Women on average tend to exercise less than men and hopefully these findings inspire more women to add extra movement to their lives.”       

The researchers found a link between women experiencing greater reduced risks for death compared to men among all types of exercise . This included moderate aerobic activity, such as brisk walking; vigorous exercise, such as taking a spinning class or jumping rope; and strength training, which could include body-weight exercises.

Scientists found that for moderate aerobic physical activity, the reduced risk for death plateaued for both men and women at 300 minutes, or five hours, per week. At this level of activity, women and men reduced their risk of premature death by 24% and 18% respectively. Similar trends were seen with 110 minutes of weekly vigorous aerobic exercise, which correlated with a 24% reduced risk of death for women and a 19% reduced risk for men.   

Women also achieved the same benefits as men but in shorter amounts of time. For moderate aerobic exercise, they met the 18% reduced risk mark in half the time needed for men: 140 minutes, or under 2.5 hours, per week, compared to 300 minutes for men. With vigorous aerobic exercise, women met the 19% reduced risk mark with just 57 minutes a week, compared to 110 minutes needed by men. 

This benefit applied to weekly strength training exercises, too. Women and men who participated in strength-based exercises had a 19% and 11% reduced risk for death, respectively, compared to those who did not participate in these exercises. Women who did strength training saw an even greater reduced risk of cardiovascular-related deaths – a 30% reduced risk, compared to 11% for men.   

For all the health benefits of exercise for both groups, however, only 33% of women and 43% of men in the study met the standard for weekly aerobic exercise, while 20% of women and 28% of men completed a weekly strength training session.  

“Even a limited amount of regular exercise can provide a major benefit, and it turns out this is especially true for women,” said Cheng. “Taking some regular time out for exercise, even if it’s just 20-30 minutes of vigorous exercise a few times each week, can offer a lot more gain than they may realize.”  

“This study emphasizes that there is no singular  approach for exercise,” said Eric J. Shiroma, Sc.D., a program director in the  Clinical Applications and Prevention branch at the National Heart, Lung, and Blood Institute (NHLBI). “A person’s physical activity needs and goals may change based on their age, health status, and schedule – but the value of any type of exercise is irrefutable.”  

The authors said multiple factors, including variations in anatomy and physiology, may account for the differences in outcomes between the sexes. For example, men often have increased lung capacity, larger hearts, more lean-body mass, and a greater proportion of fast-twitch muscle fibers compared to women. As a result, women may use added respiratory, metabolic, and strength demands to conduct the same movement and in turn reap greater health rewards.  

The Physical Activity Guidelines for Americans  recommend adults get at least 2.5-5 hours of moderate-intensity exercise or 1.25-2.5 hours of vigorous exercise each week, or a combination of both, and participate in two or more days a week of strength-based activities.  

The research was partially supported by NHLBI grants  K23HL153888 ,  R21HL156132 ,  R01HL142983 ,  R01HL151828 ,  R01HL131532 , and R01HL143227 . 

Ji H, Gulati M, Huang TY, et al. Sex differences in association of physical activity with all-cause and cardiovascular mortality. J Am Coll Cardiol. 2024; doi: 10.1016/j.jacc.2023.12.019.  

About the National Heart, Lung, and Blood Institute (NHLBI):  NHLBI is the global leader in conducting and supporting research in heart, lung, and blood diseases and sleep disorders that advances scientific knowledge, improves public health, and saves lives. For more information, visit  www.nhlbi.nih.gov .

About the National Institutes of Health (NIH):  NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit  www.nih.gov .

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  • Research article
  • Open access
  • Published: 16 November 2020

Exercise/physical activity and health outcomes: an overview of Cochrane systematic reviews

  • Pawel Posadzki 1 , 2 ,
  • Dawid Pieper   ORCID: orcid.org/0000-0002-0715-5182 3 ,
  • Ram Bajpai 4 ,
  • Hubert Makaruk 5 ,
  • Nadja Könsgen 3 ,
  • Annika Lena Neuhaus 3 &
  • Monika Semwal 6  

BMC Public Health volume  20 , Article number:  1724 ( 2020 ) Cite this article

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Sedentary lifestyle is a major risk factor for noncommunicable diseases such as cardiovascular diseases, cancer and diabetes. It has been estimated that approximately 3.2 million deaths each year are attributable to insufficient levels of physical activity. We evaluated the available evidence from Cochrane systematic reviews (CSRs) on the effectiveness of exercise/physical activity for various health outcomes.

Overview and meta-analysis. The Cochrane Library was searched from 01.01.2000 to issue 1, 2019. No language restrictions were imposed. Only CSRs of randomised controlled trials (RCTs) were included. Both healthy individuals, those at risk of a disease, and medically compromised patients of any age and gender were eligible. We evaluated any type of exercise or physical activity interventions; against any types of controls; and measuring any type of health-related outcome measures. The AMSTAR-2 tool for assessing the methodological quality of the included studies was utilised.

Hundred and fifty CSRs met the inclusion criteria. There were 54 different conditions. Majority of CSRs were of high methodological quality. Hundred and thirty CSRs employed meta-analytic techniques and 20 did not. Limitations for studies were the most common reasons for downgrading the quality of the evidence. Based on 10 CSRs and 187 RCTs with 27,671 participants, there was a 13% reduction in mortality rates risk ratio (RR) 0.87 [95% confidence intervals (CI) 0.78 to 0.96]; I 2  = 26.6%, [prediction interval (PI) 0.70, 1.07], median effect size (MES) = 0.93 [interquartile range (IQR) 0.81, 1.00]. Data from 15 CSRs and 408 RCTs with 32,984 participants showed a small improvement in quality of life (QOL) standardised mean difference (SMD) 0.18 [95% CI 0.08, 0.28]; I 2  = 74.3%; PI -0.18, 0.53], MES = 0.20 [IQR 0.07, 0.39]. Subgroup analyses by the type of condition showed that the magnitude of effect size was the largest among patients with mental health conditions.

There is a plethora of CSRs evaluating the effectiveness of physical activity/exercise. The evidence suggests that physical activity/exercise reduces mortality rates and improves QOL with minimal or no safety concerns.

Trial registration

Registered in PROSPERO ( CRD42019120295 ) on 10th January 2019.

Peer Review reports

The World Health Organization (WHO) defines physical activity “as any bodily movement produced by skeletal muscles that requires energy expenditure” [ 1 ]. Therefore, physical activity is not only limited to sports but also includes walking, running, swimming, gymnastics, dance, ball games, and martial arts, for example. In the last years, several organizations have published or updated their guidelines on physical activity. For example, the Physical Activity Guidelines for Americans, 2nd edition, provides information and guidance on the types and amounts of physical activity that provide substantial health benefits [ 2 ]. The evidence about the health benefits of regular physical activity is well established and so are the risks of sedentary behaviour [ 2 ]. Exercise is dose dependent, meaning that people who achieve cumulative levels several times higher than the current recommended minimum level have a significant reduction in the risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events [ 3 ]. Benefits of physical activity have been reported for numerous outcomes such as mortality [ 4 , 5 ], cognitive and physical decline [ 5 , 6 , 7 ], glycaemic control [ 8 , 9 ], pain and disability [ 10 , 11 ], muscle and bone strength [ 12 ], depressive symptoms [ 13 ], and functional mobility and well-being [ 14 , 15 ]. Overall benefits of exercise apply to all bodily systems including immunological [ 16 ], musculoskeletal [ 17 ], respiratory [ 18 ], and hormonal [ 19 ]. Specifically for the cardiovascular system, exercise increases fatty acid oxidation, cardiac output, vascular smooth muscle relaxation, endothelial nitric oxide synthase expression and nitric oxide availability, improves plasma lipid profiles [ 15 ] while at the same time reducing resting heart rate and blood pressure, aortic valve calcification, and vascular resistance [ 20 ].

However, the degree of all the above-highlighted benefits vary considerably depending on individual fitness levels, types of populations, age groups and the intensity of different physical activities/exercises [ 21 ]. The majority of guidelines in different countries recommend a goal of 150 min/week of moderate-intensity aerobic physical activity (or equivalent of 75 min of vigorous-intensity) [ 22 ] with differences for cardiovascular disease [ 23 ] or obesity prevention [ 24 ] or age groups [ 25 ].

There is a plethora of systematic reviews published by the Cochrane Library critically evaluating the effectiveness of physical activity/exercise for various health outcomes. Cochrane systematic reviews (CSRs) are known to be a source of high-quality evidence. Thus, it is not only timely but relevant to evaluate the current knowledge, and determine the quality of the evidence-base, and the magnitude of the effect sizes given the negative lifestyle changes and rising physical inactivity-related burden of diseases. This overview will identify the breadth and scope to which CSRs have appraised the evidence for exercise on health outcomes; and this will help in directing future guidelines and identifying current gaps in the literature.

The objectives of this research were to a. answer the following research questions: in children, adolescents and adults (both healthy and medically compromised) what are the effects (and adverse effects) of exercise/physical activity in improving various health outcomes (e.g., pain, function, quality of life) reported in CSRs; b. estimate the magnitude of the effects by pooling the results quantitatively; c. evaluate the strength and quality of the existing evidence; and d. create recommendations for future researchers, patients, and clinicians.

Our overview was registered with PROSPERO (CRD42019120295) on 10th January 2019. The Cochrane Handbook for Systematic Reviews of interventions and Preferred Reporting Items for Overviews of Reviews were adhered to while writing and reporting this overview [ 26 , 27 ].

Search strategy and selection criteria

We followed the practical guidance for conducting overviews of reviews of health care interventions [ 28 ] and searched the Cochrane Database of Systematic Reviews (CDSR), 2019, Issue 1, on the Cochrane Library for relevant papers using the search strategy: (health) and (exercise or activity or physical). The decision to seek CSRs only was based on three main aspects. First, high quality (CSRs are considered to be the ‘gold methodological standard’) [ 29 , 30 , 31 ]. Second, data saturation (enough high-quality evidence to reach meaningful conclusions based on CSRs only). Third, including non-CSRs would have heavily increased the issue of overlapping reviews (also affecting data robustness and credibility of conclusions). One reviewer carried out the searches. The study screening and selection process were performed independently by two reviewers. We imported all identified references into reference manager software EndNote (X8). Any disagreements were resolved by discussion between the authors with third overview author acting as an arbiter, if necessary.

We included CSRs of randomised controlled trials (RCTs) involving both healthy individuals and medically compromised patients of any age and gender. Only CSRs assessing exercise or physical activity as a stand-alone intervention were included. This included interventions that could initially be taught by a professional or involve ongoing supervision (the WHO definition). Complex interventions e.g., assessing both exercise/physical activity and behavioural changes were excluded if the health effects of the interventions could not have been attributed to exercise distinctly.

Any types of controls were admissible. Reviews evaluating any type of health-related outcome measures were deemed eligible. However, we excluded protocols or/and CSRs that have been withdrawn from the Cochrane Library as well as reviews with no included studies.

Data analysis

Three authors (HM, ALN, NK) independently extracted relevant information from all the included studies using a custom-made data collection form. The methodological quality of SRs included was independently evaluated by same reviewers using the AMSTAR-2 tool [ 32 ]. Any disagreements on data extraction or CSR quality were resolved by discussion. The entire dataset was validated by three authors (PP, MS, DP) and any discrepant opinions were settled through discussions.

The results of CSRs are presented in a narrative fashion using descriptive tables. Where feasible, we presented outcome measures across CSRs. Data from the subset of homogeneous outcomes were pooled quantitatively using the approach previously described by Bellou et al. and Posadzki et al. [ 33 , 34 ]. For mortality and quality of life (QOL) outcomes, the number of participants and RCTs involved in the meta-analysis, summary effect sizes [with 95% confidence intervals (CI)] using random-effects model were calculated. For binary outcomes, we considered relative risks (RRs) as surrogate measures of the corresponding odds ratio (OR) or risk ratio/hazard ratio (HR). To stabilise the variance and normalise the distributions, we transformed RRs into their natural logarithms before pooling the data (a variation was allowed, however, it did not change interpretation of results) [ 35 ]. The standard error (SE) of the natural logarithm of RR was derived from the corresponding CIs, which was either provided in the study or calculated with standard formulas [ 36 ]. Binary outcomes reported as risk difference (RD) were also meta-analysed if two more estimates were available. For continuous outcomes, we only meta-analysed estimates that were available as standardised mean difference (SMD), and estimates reported with mean differences (MD) for QOL were presented separately in a supplementary Table  9 . To estimate the overall effect size, each study was weighted by the reciprocal of its variance. Random-effects meta-analysis, using DerSimonian and Laird method [ 37 ] was applied to individual CSR estimates to obtain a pooled summary estimate for RR or SMD. The 95% prediction interval (PI) was also calculated (where ≥3 studies were available), which further accounts for between-study heterogeneity and estimates the uncertainty around the effect that would be anticipated in a new study evaluating that same association. I -squared statistic was used to measure between study heterogeneity; and its various thresholds (small, substantial and considerable) were interpreted considering the size and direction of effects and the p -value from Cochran’s Q test ( p  < 0.1 considered as significance) [ 38 ]. Wherever possible, we calculated the median effect size (with interquartile range [IQR]) of each CSR to interpret the direction and magnitude of the effect size. Sub-group analyses are planned for type and intensity of the intervention; age group; gender; type and/or severity of the condition, risk of bias in RCTs, and the overall quality of the evidence (Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria). To assess overlap we calculated the corrected covered area (CCA) [ 39 ]. All statistical analyses were conducted on Stata statistical software version 15.2 (StataCorp LLC, College Station, Texas, USA).

The searches generated 280 potentially relevant CRSs. After removing of duplicates and screening, a total of 150 CSRs met our eligibility criteria [ 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , 122 , 123 , 124 , 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 , 133 , 134 , 135 , 136 , 137 , 138 , 139 , 140 , 141 , 142 , 143 , 144 , 145 , 146 , 147 , 148 , 149 , 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 , 160 , 161 , 162 , 163 , 164 , 165 , 166 , 167 , 168 , 169 , 170 , 171 , 172 , 173 , 174 , 175 , 176 , 177 , 178 , 179 , 180 , 181 , 182 , 183 , 184 , 185 , 186 , 187 , 188 , 189 ] (Fig.  1 ). Reviews were published between September 2002 and December 2018. A total of 130 CSRs employed meta-analytic techniques and 20 did not. The total number of RCTs in the CSRs amounted to 2888; with 485,110 participants (mean = 3234, SD = 13,272). The age ranged from 3 to 87 and gender distribution was inestimable. The main characteristics of included reviews are summarised in supplementary Table  1 . Supplementary Table  2 summarises the effects of physical activity/exercise on health outcomes. Conclusions from CSRs are listed in supplementary Table  3 . Adverse effects are listed in supplementary Table  4 . Supplementary Table  5 presents summary of withdrawals/non-adherence. The methodological quality of CSRs is presented in supplementary Table  6 . Supplementary Table  7 summarises studies assessed at low risk of bias (by the authors of CSRs). GRADE-ings of the review’s main comparison are listed in supplementary Table  8 .

figure 1

Study selection process

There were 54 separate populations/conditions, considerable range of interventions and comparators, co-interventions, and outcome measures. For detailed description of interventions, please refer to the supplementary tables . Most commonly measured outcomes were - function 112 (75%), QOL 83 (55%), AEs 70 (47%), pain 41 (27%), mortality 28 (19%), strength 30 (20%), costs 47 (31%), disability 14 (9%), and mental health in 35 (23%) CSRs.

There was a 13% reduction in mortality rates risk ratio (RR) 0.87 [95% CI 0.78 to 0.96]; I 2  = 26.6%, [PI 0.70, 1.07], median effect size (MES) = 0.93 [interquartile range (IQR) 0.81, 1.00]; 10 CSRs, 187 RCTs, 27,671 participants) following exercise when compared with various controls (Table 1 ). This reduction was smaller in ‘other groups’ of patients when compared to cardiovascular diseases (CVD) patients - RR 0.97 [95% CI 0.65, 1.45] versus 0.85 [0.76, 0.96] respectively. The effects of exercise were not intensity or frequency dependent. Sessions more than 3 times per week exerted a smaller reduction in mortality as compared with sessions of less than 3 times per week RR 0.87 [95% CI 0.78, 0.98] versus 0.63 [0.39, 1.00]. Subgroup analyses by risk of bias (ROB) in RCTs showed that RCTs at low ROB exerted smaller reductions in mortality when compared to RCTs at an unclear or high ROB, RR 0.90 [95% CI 0.78, 1.02] versus 0.72 [0.42, 1.22] versus 0.86 [0.69, 1.06] respectively. CSRs with moderate quality of evidence (GRADE), showed slightly smaller reductions in mortality when compared with CSRs that relied on very low to low quality evidence RR 0.88 [95% CI 0.79, 0.98] versus 0.70 [0.47, 1.04].

Exercise also showed an improvement in QOL, standardised mean difference (SMD) 0.18 [95% CI 0.08, 0.28]; I 2  = 74.3%; PI -0.18, 0.53], MES = 0.20 [IQR 0.07, 0.39]; 15 CSRs, 408 RCTs, 32,984 participants) when compared with various controls (Table 2 ). These improvements were greater observed for health related QOL when compared to overall QOL SMD 0.30 [95% CI 0.21, 0.39] vs 0.06 [− 0.08, 0.20] respectively. Again, the effects of exercise were duration and frequency dependent. For instance, sessions of more than 90 mins exerted a greater improvement in QOL as compared with sessions up to 90 min SMD 0.24 [95% CI 0.11, 0.37] versus 0.22 [− 0.30, 0.74]. Subgroup analyses by the type of condition showed that the magnitude of effect was the largest among patients with mental health conditions, followed by CVD and cancer. Physical activity exerted negative effects on QOL in patients with respiratory conditions (2 CSRs, 20 RCTs with 601 patients; SMD -0.97 [95% CI -1.43, 0.57]; I 2  = 87.8%; MES = -0.46 [IQR-0.97, 0.05]). Subgroup analyses by risk of bias (ROB) in RCTs showed that RCTs at low or unclear ROB exerted greater improvements in QOL when compared to RCTs at a high ROB SMD 0.21 [95% CI 0.10, 0.31] versus 0.17 [0.03, 0.31]. Analogically, CSRs with moderate to high quality of evidence showed slightly greater improvements in QOL when compared with CSRs that relied on very low to low quality evidence SMD 0.19 [95% CI 0.05, 0.33] versus 0.15 [− 0.02, 0.32]. Please also see supplementary Table  9 more studies reporting QOL outcomes as mean difference (not quantitatively synthesised herein).

Adverse events (AEs) were reported in 100 (66.6%) CSRs; and not reported in 50 (33.3%). The number of AEs ranged from 0 to 84 in the CSRs. The number was inestimable in 83 (55.3%) CSRs. Ten (6.6%) reported no occurrence of AEs. Mild AEs were reported in 28 (18.6%) CSRs, moderate in 9 (6%) and serious/severe in 20 (13.3%). There were 10 deaths and in majority of instances, the causality was not attributed to exercise. For this outcome, we were unable to pool the data as effect sizes were too heterogeneous (Table 3 ).

In 38 CSRs, the total number of trials reporting withdrawals/non-adherence was inestimable. There were different ways of reporting it such as adherence or attrition (high in 23.3% of CSRs) as well as various effect estimates including %, range, total numbers, MD, RD, RR, OR, mean and SD. The overall pooled estimates are reported in Table 3 .

Of all 16 domains of the AMSTAR-2 tool, 1876 (78.1%) scored ‘yes’, 76 (3.1%) ‘partial yes’; 375 (15.6%) ‘no’, and ‘not applicable’ in 25 (1%) CSRs. Ninety-six CSRs (64%) were scored as ‘no’ on reporting sources of funding for the studies followed by 88 (58.6%) failing to explain the selection of study designs for inclusion. One CSR (0.6%) each were judged as ‘no’ for reporting any potential sources of conflict of interest, including any funding for conducting the review as well for performing study selection in duplicate.

In 102 (68%) CSRs, there was predominantly a high risk of bias in RCTs. In 9 (6%) studies, this was reported as a range, e.g., low or unclear or low to high. Two CSRs used different terminology i.e., moderate methodological quality; and the risk of bias was inestimable in one CSR. Sixteen (10.6%) CSRs did not identify any studies (RCTs) at low risk of random sequence generation, 28 (18.6%) allocation concealment, 28 (18.6%) performance bias, 84 (54%) detection bias, 35 (23.3%) attrition bias, 18 (12%) reporting bias, and 29 (19.3%) other bias.

In 114 (76%) CSRs, limitation of studies was the main reason for downgrading the quality of the evidence followed by imprecision in 98 (65.3%) and inconsistency in 68 (45.3%). Publication bias was the least frequent reason for downgrading in 26 (17.3%) CSRs. Ninety-one (60.7%) CSRs reached equivocal conclusions, 49 (32.7%) reviews reached positive conclusions and 10 (6.7%) reached negative conclusions (as judged by the authors of CSRs).

In this systematic review of CSRs, we found a large body of evidence on the beneficial effects of physical activity/exercise on health outcomes in a wide range of heterogeneous populations. Our data shows a 13% reduction in mortality rates among 27,671 participants, and a small improvement in QOL and health-related QOL following various modes of physical activity/exercises. This means that both healthy individuals and medically compromised patients can significantly improve function, physical and mental health; or reduce pain and disability by exercising more [ 190 ]. In line with previous findings [ 191 , 192 , 193 , 194 ], where a dose-specific reduction in mortality has been found, our data shows a greater reduction in mortality in studies with longer follow-up (> 12 months) as compared to those with shorter follow-up (< 12 months). Interestingly, we found a consistent pattern in the findings, the higher the quality of evidence and the lower the risk of bias in primary studies, the smaller reductions in mortality. This pattern is observational in nature and cannot be over-generalised; however this might mean less certainty in the estimates measured. Furthermore, we found that the magnitude of the effect size was the largest among patients with mental health conditions. A possible mechanism of action may involve elevated levels of brain-derived neurotrophic factor or beta-endorphins [ 195 ].

We found the issue of poor reporting or underreporting of adherence/withdrawals in over a quarter of CSRs (25.3%). This is crucial both for improving the accuracy of the estimates at the RCT level as well as maintaining high levels of physical activity and associated health benefits at the population level.

Even the most promising interventions are not entirely risk-free; and some minor AEs such as post-exercise pain and soreness or discomfort related to physical activity/exercise have been reported. These were typically transient; resolved within a few days; and comparable between exercise and various control groups. However worryingly, the issue of poor reporting or underreporting of AEs has been observed in one third of the CSRs. Transparent reporting of AEs is crucial for identifying patients at risk and mitigating any potential negative or unintended consequences of the interventions.

High risk of bias of the RCTs evaluated was evident in more than two thirds of the CSRs. For example, more than half of reviews identified high risk of detection bias as a major source of bias suggesting that lack of blinding is still an issue in trials of behavioural interventions. Other shortcomings included insufficiently described randomisation and allocation concealment methods and often poor outcome reporting. This highlights the methodological challenges in RCTs of exercise and the need to counterbalance those with the underlying aim of strengthening internal and external validity of these trials.

Overall, high risk of bias in the primary trials was the main reason for downgrading the quality of the evidence using the GRADE criteria. Imprecision was frequently an issue, meaning the effective sample size was often small; studies were underpowered to detect the between-group differences. Pooling too heterogeneous results often resulted in inconsistent findings and inability to draw any meaningful conclusions. Indirectness and publication bias were lesser common reasons for downgrading. However, with regards to the latter, the generally accepted minimum number of 10 studies needed for quantitatively estimate the funnel plot asymmetry was not present in 69 (46%) CSRs.

Strengths of this research are the inclusion of large number of ‘gold standard’ systematic reviews, robust screening, data extractions and critical methodological appraisal. Nevertheless, some weaknesses need to be highlighted when interpreting findings of this overview. For instance, some of these CSRs analysed the same primary studies (RCTs) but, arrived at slightly different conclusions. Using, the Pieper et al. [ 39 ] formula, the amount of overlap ranged from 0.01% for AEs to 0.2% for adherence, which indicates slight overlap. All CSRs are vulnerable to publication bias [ 196 ] - hence the conclusions generated by them may be false-positive. Also, exercise was sometimes part of a complex intervention; and the effects of physical activity could not be distinguished from co-interventions. Often there were confounding effects of diet, educational, behavioural or lifestyle interventions; selection, and measurement bias were inevitably inherited in this overview too. Also, including CSRs only might lead to selection bias; and excluding reviews published before 2000 might limit the overall completeness and applicability of the evidence. A future update should consider these limitations, and in particular also including non-CSRs.

Conclusions

Trialists must improve the quality of primary studies. At the same time, strict compliance with the reporting standards should be enforced. Authors of CSRs should better explain eligibility criteria and report sources of funding for the primary studies. There are still insufficient physical activity trends worldwide amongst all age groups; and scalable interventions aimed at increasing physical activity levels should be prioritized [ 197 ]. Hence, policymakers and practitioners need to design and implement comprehensive and coordinated strategies aimed at targeting physical activity programs/interventions, health promotion and disease prevention campaigns at local, regional, national, and international levels [ 198 ].

Availability of data and materials

Data sharing is not applicable to this article as no raw data were analysed during the current study. All information in this article is based on published systematic reviews.

Abbreviations

Adverse events

Cardiovascular diseases

Cochrane Database of Systematic Reviews

Cochrane systematic reviews

Confidence interval

Grading of Recommendations Assessment, Development and Evaluation

Hazard ratio

Interquartile range

Mean difference

Prediction interval

Quality of life

Randomised controlled trials

Relative risk

Risk difference

Risk of bias

Standard error

Standardised mean difference

World Health Organization

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Pawel Posadzki

Nanyang Technological University, Singapore, Singapore

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PP wrote the protocol, ran the searches, validated, analysed and synthesised data, wrote and revised the drafts. HM, NK and ALN screened and extracted data. MS and DP validated and analysed the data. RB ran statistical analyses. All authors contributed to writing and reviewing the manuscript. PP is the guarantor. The authors read and approved the final manuscript.

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Supplementary Information

Additional file 1:.

Supplementary Table 1. Main characteristics of included Cochrane systematic reviews evaluating the effects of physical activity/exercise on health outcomes ( n  = 150). Supplementary Table 2. Additional information from Cochrane systematic reviews of the effects of physical activity/exercise on health outcomes ( n  = 150). Supplementary Table 3. Conclusions from Cochrane systematic reviews “quote”. Supplementary Table 4 . AEs reported in Cochrane systematic reviews. Supplementary Table 5. Summary of withdrawals/non-adherence. Supplementary Table 6. Methodological quality assessment of the included Cochrane reviews with AMSTAR-2. Supplementary Table 7. Number of studies assessed as low risk of bias per domain. Supplementary Table 8. GRADE for the review’s main comparison. Supplementary Table 9. Studies reporting quality of life outcomes as mean difference.

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Posadzki, P., Pieper, D., Bajpai, R. et al. Exercise/physical activity and health outcomes: an overview of Cochrane systematic reviews. BMC Public Health 20 , 1724 (2020). https://doi.org/10.1186/s12889-020-09855-3

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Tuesday, February 20, 2024

Women may realize health benefits of regular exercise more than men

An NIH-supported observational study finds that even when women and men get the same amount of physical activity, the risk of premature death is lower for women.

Women who exercise regularly have a significantly lower risk of an early death or fatal cardiovascular event than men who exercise regularly, even when women put in less effort, according to a National Institutes of Health-supported study. The findings, published in the Journal of the American College of Cardiology , are based on a prospective analysis of data from more than 400,000 U.S. adults ages 27-61 which showed that over two decades, women were 24% less likely than those who do not exercise to experience death from any cause, while men were 15% less likely. Women also had a 36% reduced risk for a fatal heart attack, stroke, or other cardiovascular event, while men had a 14% reduced risk.  

“We hope this study will help everyone, especially women, understand they are poised to gain tremendous benefits from exercise,” said Susan Cheng, M.D., a cardiologist and the Erika J. Glazer Chair in Women’s Cardiovascular Health and Population Science in the Smidt Heart Institute at Cedars-Sinai, Los Angeles. “It is an incredibly powerful way to live healthier and longer. Women on average tend to exercise less than men and hopefully these findings inspire more women to add extra movement to their lives.”    

The researchers found a link between women experiencing greater reduced risks for death compared to men among all types of exercise . This included moderate aerobic activity, such as brisk walking; vigorous exercise, such as taking a spinning class or jumping rope; and strength training, which could include body-weight exercises.

Scientists found that for moderate aerobic physical activity, the reduced risk for death plateaued for both men and women at 300 minutes, or five hours, per week. At this level of activity, women and men reduced their risk of premature death by 24% and 18% respectively. Similar trends were seen with 110 minutes of weekly vigorous aerobic exercise, which correlated with a 24% reduced risk of death for women and a 19% reduced risk for men.

Women also achieved the same benefits as men but in shorter amounts of time. For moderate aerobic exercise, they met the 18% reduced risk mark in half the time needed for men: 140 minutes, or under 2.5 hours, per week, compared to 300 minutes for men. With vigorous aerobic exercise, women met the 19% reduced risk mark with just 57 minutes a week, compared to 110 minutes needed by men.

This benefit applied to weekly strength training exercises, too. Women and men who participated in strength-based exercises had a 19% and 11% reduced risk for death, respectively, compared to those who did not participate in these exercises. Women who did strength training saw an even greater reduced risk of cardiovascular-related deaths – a 30% reduced risk, compared to 11% for men. 

For all the health benefits of exercise for both groups, however, only 33% of women and 43% of men in the study met the standard for weekly aerobic exercise, while 20% of women and 28% of men completed a weekly strength training session.

“Even a limited amount of regular exercise can provide a major benefit, and it turns out this is especially true for women,” said Cheng. “Taking some regular time out for exercise, even if it’s just 20-30 minutes of vigorous exercise a few times each week, can offer a lot more gain than they may realize.”

“This study emphasizes that there is no singular approach for exercise,” said Eric J. Shiroma, Sc.D., a program director in the Clinical Applications and Prevention branch at the National Heart, Lung, and Blood Institute (NHLBI). “A person’s physical activity needs and goals may change based on their age, health status, and schedule – but the value of any type of exercise is irrefutable.”

The authors said multiple factors, including variations in anatomy and physiology, may account for the differences in outcomes between the sexes. For example, men often have increased lung capacity, larger hearts, more lean-body mass, and a greater proportion of fast-twitch muscle fibers compared to women. As a result, women may use added respiratory, metabolic, and strength demands to conduct the same movement and in turn reap greater health rewards.

The Physical Activity Guidelines for Americans recommend adults get at least 2.5-5 hours of moderate-intensity exercise or 1.25-2.5 hours of vigorous exercise each week, or a combination of both, and participate in two or more days a week of strength-based activities.

The research was partially supported by NHLBI grants K23HL153888 , R21HL156132 , R01HL142983 , R01HL151828 , R01HL131532 , and R01HL143227 .

About the National Heart, Lung, and Blood Institute (NHLBI): NHLBI is the global leader in conducting and supporting research in heart, lung, and blood diseases and sleep disorders that advances scientific knowledge, improves public health, and saves lives. For more information, visit https://www.nhlbi.nih.gov . 

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov .

NIH…Turning Discovery Into Health ®

Ji H, Gulati M, Huang TY, et al. Sex differences in association of physical activity with all-cause and cardiovascular mortality. J Am Coll Cardiol . 2024; doi: 10.1016/j.jacc.2023.12.019.

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Activated by regular exercise, immune cells in muscles found to fend off inflammation, enhance endurance in mice

The connection between exercise and inflammation has captivated the imagination of researchers ever since an  early 20th-century study  showed a spike of white cells in the blood of Boston marathon runners following the race.

Now, a new Harvard Medical School study published Friday in Science Immunology may offer a molecular explanation behind this century-old observation.

The study, done in mice, suggests that the beneficial effects of exercise may be driven, at least partly, by the immune system. It shows that muscle inflammation caused by exertion mobilizes inflammation-countering T cells, or Tregs, which enhance the muscles’ ability to use energy as fuel and improve overall exercise endurance.

Long known for their role in countering the aberrant inflammation linked to autoimmune diseases, Tregs now also emerge as key players in the body’s immune responses during exercise, the research team said.

“The immune system, and the T cell arm in particular, has a broad impact on tissue health that goes beyond protection against pathogens and controlling cancer. Our study demonstrates that the immune system exerts powerful effects inside the muscle during exercise,” said study senior investigator  Diane Mathis , professor of immunology in the Blavatnik Institute at HMS.

Mice are not people, and the findings remain to be replicated in further studies, the researchers cautioned. However, the study is an important step toward detailing the cellular and molecular changes that occur during exercise and confer health benefits.

Understanding the molecular underpinnings of exercise

Protecting from cardiovascular disease, reducing the risk of diabetes, shielding against dementia. The salutary effects of exercise are well established. But exactly how does exercise make us healthy? The question has intrigued researchers for a long time.

The new findings come amid  intensifying efforts  to understand the molecular underpinnings of exercises. Untangling the immune system’s involvement in this process is but one aspect of these research efforts.

“Our research suggests that with exercise, we have a natural way to boost the body’s immune responses to reduce inflammation.” Diane Mathis, professor of immunology in the Blavatnik Institute

“We’ve known for a long time that physical exertion causes inflammation, but we don’t fully understand the immune processes involved,” said study first author Kent Langston, a postdoctoral researcher in the Mathis lab. “Our study shows, at very high resolution, what T cells do at the site where exercise occurs, in the muscle.”

Most previous research on exercise physiology has focused on the role of various hormones released during exercise and their effects on different organs such as the heart and the lungs. The new study unravels the immunological cascade that unfolds inside the actual site of exertion — the muscle.

T cell heroes and inflammation-fueling villains

Exercise is known to cause temporary damage to the muscles, unleashing a cascade of inflammatory responses. It boosts the expression of genes that regulate muscle structure, metabolism, and the activity of mitochondria, the tiny powerhouses that fuel cell function. Mitochondria play a key role in exercise adaptation by helping cells meet the greater energy demand of exercise.

In the new study, the team analyzed what happens in cells taken from the hind leg muscles of mice that ran on a treadmill once and animals that ran regularly. Then, the researchers compared them with muscle cells obtained from sedentary mice.

The muscle cells of the mice that ran on treadmills, whether once or regularly, showed classic signs of inflammation — greater activity in genes that regulate various metabolic processes and higher levels of chemicals that promote inflammation, including interferon.

Both groups had elevated levels of Treg cells in their muscles. Further analyses showed that in both groups, Tregs lowered exercise-induced inflammation. None of those changes were seen in the muscle cells of sedentary mice.

However, the metabolic and performance benefits of exercise were apparent only in the regular exercisers — the mice that had repeated bouts of running. In that group, Tregs not only subdued exertion-induced inflammation and muscle damage, but also altered muscle metabolism and muscle performance, the experiments showed. This finding aligns with well-established observations in humans that a single bout of exercise does not lead to significant improvements in performance and that regular activity over time is needed to yield benefits.

The hind leg muscles of mice lacking Treg cells (right) showed prominent signs of inflammation after regular exercise, compared with those from mice with intact Tregs (left). The research showed such that this uncontrolled inflammation negatively impacted muscle metabolism and function.

Credit: Kent Langston/Mathis Lab, HMS

Further analyses confirmed that Tregs were, indeed, responsible for the broader benefits seen in regular exercisers. Animals that lacked Tregs had unrestrained muscle inflammation, marked by the rapid accumulation of inflammation-promoting cells in their hind leg muscles. Their muscle cells also had strikingly swollen mitochondria, a sign of metabolic abnormality.

More importantly, animals lacking Tregs did not adapt to increasing demands of exercise over time the way mice with intact Tregs did. They did not derive the same whole-body benefits from exercise and had diminished aerobic fitness.

These animals’ muscles also had excessive amounts of interferon, a known driver of inflammation. Further analyses revealed that interferon acts directly on muscle fibers to alter mitochondrial function and limit energy production. Blocking interferon prevented metabolic abnormalities and improved aerobic fitness in mice lacking Tregs.

“The villain here is interferon,” Langston said. “In the absence of guardian Tregs to counter it, interferon went on to cause uncontrolled damage.”

Interferon is known to promote chronic inflammation, a process that underlies many chronic diseases and age-related conditions and has become a tantalizing target for therapies aimed at reducing inflammation. Tregs have also captured the attention of scientists and industry as treatments for a range of immunologic conditions marked by abnormal inflammation.

The study findings provide a glimpse into the cellular innerworkings behind exercise’s anti-inflammatory effects and underscore its importance in harnessing the body’s own immune defenses, the researchers said.

There are efforts afoot to design interventions targeting Tregs in the context of specific immune-mediated diseases. And while immunologic conditions driven by aberrant inflammation require carefully calibrated therapies, exercise is yet another way to counter inflammation, the researchers said.

“Our research suggests that with exercise, we have a natural way to boost the body’s immune responses to reduce inflammation,” Mathis said. “We’ve only looked in the muscle, but it’s possible that exercise is boosting Treg activity elsewhere in the body as well.”

Co-investigators included Yizhi Sun, Birgitta Ryback, Bruce Spiegelman, Amber Mueller, and Christophe Benoist.

The work was funded by National Institutes of Health grants R01 AR070334, F32 AG072874, and F32 AG069363; and by the JPB Foundation.

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Articles on Gym

Displaying 1 - 20 of 22 articles.

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Why banning gym selfies could do us all a lot of good

Samuel Cornell , UNSW Sydney and Timothy Piatkowski , Griffith University

research on gym

What are dead hangs? What are the shoulder pain risks and how do I do them safely?

Charlotte Ganderton , Swinburne University of Technology and Sarah Warby , La Trobe University

research on gym

Lift heavy or smaller weights with high reps? It all depends on your goal

Mandy Hagstrom , UNSW Sydney

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Melbourne lockdown: why can’t gyms open yet but hospitality venues can?

Brett Mitchell , University of Newcastle and Philip Russo , Monash University

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Heading back to the gym? Here’s how to avoid injury after coronavirus isolation

Christopher Williams , University of Newcastle

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Heading back to the gym? Here’s how you can protect yourself and others from coronavirus infection

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Why your New Year’s resolution to go to the gym will fail

William Clark , Binghamton University, State University of New York

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Six-packs and bulging biceps – how appearance pressures take their toll on men’s mental health

Glen Jankowski , Leeds Beckett University

research on gym

It’s not all gym junkies and ‘roid rage’ – people use steroids for a variety of reasons

Katinka van de Ven , UNSW Sydney and Kyle J.D. Mulrooney , University of New England

research on gym

Health check: can caffeine improve your exercise performance?

Jozo Grgic , Victoria University ; Brad Schoenfeld , City University of New York ; Craig Pickering , University of Central Lancashire ; David Bishop , Victoria University ; Pavle Mikulic , and Željko Pedišić , Victoria University

research on gym

Gym membership: how to get the most out of it, according to a sports scientist

Neil Gibson , Heriot-Watt University

research on gym

Can coffee improve your workout? The science of caffeine and exercise

Neil Clarke , Coventry University

research on gym

Strength training can have unique health benefits, and it doesn’t have to happen in a gym

Emmanuel Stamatakis , University of Sydney

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BCAA supplements are just hype – here’s a better way to build muscles

Lee Hamilton , University of Stirling ; Brad Schoenfeld , City University of New York , and Kevin Tipton , University of Stirling

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Can trying to meet specific exercise goals put us off being active altogether?

Christian Swann , University of Wollongong and Simon Rosenbaum , UNSW Sydney

research on gym

Doping among amateur athletes like CrossFitters is probably more common than you’d think

Kyle J.D. Mulrooney , University of Kent and Katinka van de Ven , UNSW Sydney

research on gym

Is it safe to take exercise supplements?

Philip J Atherton , University of Nottingham and Daniel J Wilkinson , University of Nottingham

research on gym

Why terms like ‘shred, burn and melt’ belong in the kitchen, not the gym

Naroa Etxebarria , University of Canberra

research on gym

Q&A: How often do we need to go to the gym? (And other exercise questions answered)

James Brown , Aston University

research on gym

No time to exercise? Then this training programme might be for you

Damien Gleadall-Siddall , University of Hull

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How to Thrive as You Age

Millions of women are 'under-muscled.' these foods help build strength.

Allison Aubrey - 2015 square

Allison Aubrey

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This tuna, chickpea and parmesan salad bowl packs a protein punch, which is crucial for building muscle strength. Allison Aubrey/NPR hide caption

This tuna, chickpea and parmesan salad bowl packs a protein punch, which is crucial for building muscle strength.

If you've seen a loved one take a bad fall – like my mother did a few months ago – you know the importance of muscle strength.

Muscle mass peaks in our 30s and then starts a long, slow decline. Muscle-loss, also called sarcopenia , affects more than 45% of older Americans , especially women.

"As a country, we are under-muscled," says Richard Joseph , a wellness-focused physician. It's a key culprit of physical decline.

Loss of strength increases the risk of falling, the top cause of death from injury in older adults. The Office on Women's Health recently launched a sarcopenia awareness campaign to elevate the issue.

The good news: No matter your age, you can take steps to maximize your strength. Resistance training is key, but equally important, is eating adequate amounts of protein.

If you don't consume enough protein, "you're missing half of the equation," says nutrition and exercise scientist Rachele Pojednic, a researcher at Stanford Lifestyle Medicine. But millions of older women in the U.S. don't consume enough protein, research shows.

Protein is critically important because it's in all our cells — including muscle cells — and our bodies constantly recycle it. There's a steady demand for new supplies, and protein-rich foods provide the amino acids that become the building blocks of the new proteins our bodies need.

As we age, the goal is to consume protein from food at a faster rate than our body is breaking it down. When you add in resistance training, this will help maintain muscle mass, Pojednic says.

So how much is enough? The recommended intake is a minimum of 0.8 grams of protein per kilogram of body weight. That's about 0.36 grams of protein multiplied by your weight in pounds. That means a person who weighs 150 pounds should consume at least 54 grams of protein a day.

But many experts say more is optimal. As we age, protein needs to increase. And if you are exercising a lot – which is the way to build new muscle — you may benefit from even more.

Sports medicine experts recommend up to 1.7 grams of protein per kilogram of body weight each day for people who are actively training, which is about 115 grams for a 150 pound person.

Most young adults tend to consume the recommended amounts of protein. But, later in life, a study from 2019 found about 30% of men in their 50s and 60s fall short, and nearly half of women aged 50 and older do.

So, as part of my project on healthy aging , I decided to up my protein intake. I was advised to aim for 90 grams of protein a day, which, at first I found challenging. So, I asked experts to share some key foods and strategies to help pack more protein into my meals. Here are some ideas:

research on gym

Here's an example of a high-protein breakfast. Estimates are from food labels and this protein guide from Kaiser Permanente. Allison Aubrey/Katie Hayes Luke/NPR hide caption

Here's an example of a high-protein breakfast. Estimates are from food labels and this protein guide from Kaiser Permanente.

1. Amp up your morning bowl of Greek yogurt

At about 17 grams per ¾ cup serving, Greek yogurt is a great source of protein. You can eat it plain, add sweet or savory toppings, or throw it into a smoothie. "It's super versatile and high in casein protein, which is slow to digest, which keeps you full while also promoting muscle protein synthesis," which is the process of building muscle mass, Pojednic says.

2. Eggs are an easy way to get protein on the go

At 6 grams of protein for a large egg, hard boiled eggs are a go-to option. If you hard boil a dozen eggs and keep them in the refrigerator, they're ready to grab and go. And, whether you like scrambled or poached, eating an egg in the morning - or as a mid-morning snack, can hold you to lunch. The U.S. Dietary Guidelines say an egg a day won't raise heart disease risk in healthy people, but some adults may need to limit eggs due to cholesterol concerns.

Nutrition Panel: Egg With Coffee Is A-OK, But Skip The Side Of Bacon

Nutrition Panel: Egg With Coffee Is A-OK, But Skip The Side Of Bacon

3. power up your smoothies with powdered protein.

If you've got a blender and some fruits and veg on hand, you're ready to go. "We have a big smoothie game in our house," Joseph says. "I love smoothies, my kids love smoothies," he says and it's easy to add extra protein by blending in a scoop of protein powder. Whey protein powder, which is derived from the cheesemaking process when whey and curds are separated, has all of the essential amino acids our bodies need, and it's another great option for high protein on the go. I like to buy big bags of frozen berries for my smoothies and toss in spirulina , an algae that's high in protein. Also, if my bananas or greens are getting too ripe, I add them, so they don't go to waste.

research on gym

The parmesan cheese on this tuna and chickpea salad has a surprising amount of protein. Allison Aubrey/Katie Hayes Luke/NPR hide caption

The parmesan cheese on this tuna and chickpea salad has a surprising amount of protein.

4. Add some tuna to your salad

Fish is chockablock full of protein. Cod has approximately 40 grams per serving and salmon and tuna both have approximately 30 grams. And Rachele Pojednic says fish is an excellent source of unsaturated, rather than saturated fat, so that's a plus for heart health. One super simple option is to toss a can of strained tuna over a bed of greens, then add fruit and nuts for crunch. And, voilà, you've hit your protein target!

5. Sprinkle in protein with nuts and seeds

Nuts and seeds tend to be about the same – or even better – in the protein category than legumes, so try sprinkling them on salads and rice bowls, Pojednic says. Hemp and pumpkin seeds both have around 8 grams for a ¼ cup serving, and you can add them as healthy "crunchies" on top of yogurt, oatmeal, salads or bowls, she says. Pumpkin seeds also contain plenty of magnesium, beneficial for heart health.

6. Meat in small doses adds a protein punch

Meat is a top source of protein, serving up about 7 grams of protein per ounce , and many dietitians say to aim for lean cuts, such as chicken breast or lean ground turkey. But as many people aim to cut back, there are plenty of plant-based alternatives. A new study published in the American Journal of Clinical Nutrition this month finds adequate protein intake in midlife – especially plant protein – is linked to significantly higher odds of healthy aging.

research on gym

This high-protein dinner features eggplant stuffed with black beans. Allison Aubrey/Katie Hayes Luke/NPR hide caption

This high-protein dinner features eggplant stuffed with black beans.

7. Tasty ways to eat tofu and beans

Lentils and chickpeas are two of my favorite plant protein sources, which are delicious on their own or in curries and soups. You can also cook up a potful and keep them in the fridge ready to add to salads. There's also tofu and edamame, which are affordable and available at most supermarkets. Lesser known options include Tempeh (soy based) which comes in at approximately 18-20 grams of protein per serving. Here's a hack to prevent tofu mush: I sprinkle a little cornstarch on diced tofu and pan fry it, which makes it crispy on the outside. Then I toss in sauces, such as peanut sauce or pesto.

8. Don't miss out higher-protein grains

I love the nutty taste and chewy texture of farro , an ancient grain that's won over a lot of fans. It's easy to cook – just toss the grain into boiling water and let it simmer. A few cups makes enough for several meals. At twice the protein, it's an "awesome swap for rice," Pojednic says. And farro also has a lot more fiber. Quinoa is another good option, it has approximately 8 grams of protein per cup.

Eating Leafy Greens Each Day Tied to Sharper Memory, Slower Decline

Shots - Health News

Eating leafy greens each day tied to sharper memory, slower decline, 9. don't forget veggies.

Vegetables are not the main players when it comes to protein, but they can add a few grams. For instance, a cup of broccoli contains about 2.6 grams. And greens and colorful vegetables contain many beneficial vitamins, micronutrients and antioxidant compounds which are good for health. Eating a salad a day is linked to a sharper memory , too. So keep a bowl of chopped vegetables to snack on and blend into salads, stews and soups.

We'd like to hear – or see – how you are packing protein into your diet. You can share your tips and photos here in the form below. Or drop us a line at [email protected]

This story was edited by Jane Greenhalgh & Carmel Wroth

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  • Review Article
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  • Published: 17 August 2023

A systematic review of intention to use fitness apps (2020–2023)

  • Salvador Angosto   ORCID: orcid.org/0000-0001-7281-794X 1 , 2 ,
  • Jerónimo García-Fernández   ORCID: orcid.org/0000-0001-6574-9758 2   na1 &
  • Moisés Grimaldi-Puyana   ORCID: orcid.org/0000-0003-4722-1532 2   na1  

Humanities and Social Sciences Communications volume  10 , Article number:  512 ( 2023 ) Cite this article

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Technology advances and digital transformation are constantly growing, resulting in an increase in the number of sports-related technologies and apps on the market, particularly during the COVID-19 pandemic. The aim of this study is to update a comprehensive evaluation of the literature published since 2020 on the desire to use and embrace fitness and physical activity-related apps. Using the PERSiST adapted from the PRISMA 2020 statement, a total of 29 articles that provide assessment models of sports consumers’ desires to utilise fitness applications were discovered. Several major conclusions emerge from the findings: (1) the use of alternative models to the Technology Acceptance Model has increased in recent years with new theories not derived from that model now being associated with it; (2) studies in Europe are increasing as well as a specifical interest in fitness apps; (3) the UTAUT and UTAUT2 model are more widely used within the sport sector and new models appear connected with behaviour intentions; and (4) the number of exogenous and endogenous variables that are linked to the main technology acceptance variables and their behavioral intentions is diverse within the academic literature. These findings could help technology managers to increase user communication, physical activity levels and participation in their fitness centres, as well as to modify the policies and services of sports organisations.

Introduction

In recent years, the number of smartphone users has steadily increased throughout the world, with nearly half of the population now owning a device (Newzoo, 2021 ). As a result, the smartphone is quickly becoming a vital instrument in the lives of the general public (Byun et al., 2018 ). This digital change can also be found in the sports and fitness industry, where the digital explosion in the usage of smartphones and wearables has allowed fitness apps to become one of the market’s most important categories (Jones et al., 2020 ).

Fitness apps are swamping the mobile app market (Beldad and Hegner, 2018 ), with almost one in every five users downloading this type of app on their device (Fox and Duggan, 2021 ). Due to the lockdown placed on people and the requirement to stay at home, the demand for fitness apps has grown significantly since the onset of the COVID-19 pandemic (Clement, 2020 ; Ting et al., 2020 ). A fitness app is a third-party programme for smartphones or wearables that may help consumers in recording physical activity data, guiding sports learning and leading a healthy lifestyle (Eshet and Bouwman, 2015 ). A recent study conducted a social comparison of fitness-related posts on social media platforms by fitness app users. Specifically, Kim ( 2022 ) found that when fitness comparison decreased there was a decrease in user self-efficacy towards physical activity, whereas if fitness comparison increased, self-efficacy towards physical activity increased. Consequently, Kim ( 2022 ) highlighted that self-efficacy is a key element for fitness app users’ motivation and participation in physical activity, and they should be compared to high-performing individuals. In addition, gamification is another important element concerning fitness apps for user satisfaction, and a specific design adapted to the type of user is necessary given the number of existing elements in gamification, highlighting feedback and rewards (Yin et al., 2022 ).

The popularity of fitness apps has grown over the years, coinciding with a greater understanding of the value and advantages of physical activity and a healthy lifestyle (Lim and Noh, 2017 ). Fitness apps have become a trend in the worldwide fitness sector, resulting in new patterns of training behaviour (Hu et al., 2023 ; Kercher et al., 2022 ; Thompson, 2022 ). These new behaviour patterns are connected to physical activity monitoring, a shift in health-care perceptions, and changes in lifestyle habits (Lin et al., 2019 ). Middelweerd et al. ( 2014 ), for their part, emphasise that fitness apps employ many behaviour modification approaches such as goal planning, self-control, feedback, the use of contingent incentives and social support.

In the fitness context, it is also important to address the importance that apps can have in the management of sports centres as a two-way communication tool between the organisation (managers or trainers) and users. In this way, Ferreira-Barbosa et al. ( 2021 ) consider that the use of notifications and communications through the fitness app costs less and produces a greater and better interaction with the client. Thus, the use of applications in fitness centres can enable more direct and dynamic communication with users, providing a better and more personalised service.

Despite this, while studies have begun to find the factors that lead to the desire of using technologies such as apps in numerous fields (Gao et al., 2012 ), a deeper knowledge of the intention to use using certain apps is required (Cho et al., 2020 ). As a result, there are several theoretical frameworks in the scientific literature that explain the acceptance of new technology by sports customers. This ‘acceptance of technology’ refers to an individual’s readiness to adopt technology (Dillon, 2001 ).

The technology adoption model (TAM) developed by Davis ( 1989 ) and Davis et al. ( 1989 ) is the principal model utilised in most research to quantify consumer acceptance of new technologies. The TAM assumes an extension of Ajzen and Fishbein’s ( 1980 ) Theory of Reasoned Action, in which the behavioural intention is decided by the attitude towards this conduct (Davis, 1989 ). According to this author, attitudes are developed around two beliefs: perceived usefulness (PU) and perceived ease of use (PEOU). PU is described as the individual’s belief about the worth of a system, such as its performance or efficiency, in order to gain an advantage, while PEOU is defined as the degree to which the individual believes that the system requires no physical or mental effort and is easily accessible (Davis, 1989 ; Davis et al., 1989 ). PU and PEOU provide for the prediction of user intentions in relation to the adoption of both devices and mobile apps (Kim et al., 2016 ; Koenig-Lewis et al., 2015 ). The TAM has been employed in a variety of areas, including finance, tourism, gaming, health and sports (Rivera et al., 2015 ).

A number of TAM-based theories have been established, including the technology readiness and acceptance model (TRAM), which is derived from the TAM and the "Technology Readiness" (TR) model. Parasuraman ( 2000 ) created the TR with the goal of reflecting consumers’ views and dispositions to implement new technologies, linking their usage with the fulfilment of personal or work objectives. The TRAM has been used in a variety of apps, including social innovation (Rahman et al., 2017 ), branding (Jin, 2020 ) and sports technology (Kim and Chiu, 2019 ). Venkatesh and Davis ( 2000 ) introduced the TAM2 model, which integrates social influence and cognitive belief processes. Other models developed from the TAM are those proposed by Venkatesh et al. ( 2003 ), who suggested the Unified Theory of Acceptance and Use of Technology (UTAUT), its extension called UTAUT2 proposed by Venkatesh et al. ( 2012 ) and UTAUT3 proposed by Farooq et al. ( 2017 ). These theories are concerned with both customers and users (Ferreira et al., 2021 ). According to Venkatesh et al. ( 2003 ), the UTAUT model identifies four elements that influence ‘intention to use’: (i) performance expectancy (PE), or the degree to which individuals believe that using the system will allow them to improve their work performance; (ii) effort expectancy (EE), or the degree to which individuals believe that using the system will allow them to improve their work performance; (iii) social influence (SI), defined as the degree to which individuals believe that their social referents believe that they should use the system; and (iv) facilitating conditions (FC), identified as the degree to which the individual believes in the existence of a technical and organisational benefit.

In addition to the four factors derived from the UTAUT model, the UTAUT2 approach integrates three additional variables (Venkatesh et al., 2012 ): (i) hedonic motivation (HM), which reflects the individual’s intrinsic motivations for accepting new technology; (ii) price value (PV) considered as acceptance of the cost involved in using new technology; and (iii) habit (HA) or the degree to which the individual tends to use the new technology automatically after a learning process. Regarding the UTAUT3 model, Farooq et al. ( 2017 ) introduce a new variable, Personal Innovativeness (PI). Dutta et al. ( 2015 ) indicate that personality traits, such as PI, play an essential role in Information Technology (IT) adoption. As a trait, PI is stable and situation-specific and has a high tendency to influence IT adoption and acceptance (Farooq et al., 2017 ; Thatcher and Perrewé, 2002 ). Thus, PI can be defined as the perceived predisposition or personal attitude of individuals that reflect their tendency to independently experience and adopt new developments in IT (Schillewaert et al., 2005 ). This means that PI can be conceptualised as the willingness to adopt the latest technological gadgets or be linked to trying out new IT features and developments (Farooq et al., 2017 ).

Figure 1 shows the conceptual model of the different theories discussed (TAM, UAUT, UAUT2, UTAUT3). The UTAUT and the UTAUT2 models were performed to investigate consumer acceptance and usage of new technologies (Beh et al., 2021 ), and have been used in a variety of research in the sports, fitness and wearable sectors (Beh et al., 2021 ; Dhiman et al., 2020 ; Yuan et al., 2015 ). However, the UTAUT3 model has not yet been used in the sport context, but it has been employed in other contexts such as tourism (Pinto et al., 2022 ), virtual communication (Gupta et al., 2022 ) and education (Gunasinghe et al., 2020 ).

figure 1

TAM (Davis, 1989 ), UAUT (Venkatesh et al., 2003 ), UAUT2 (Venkatesh et al., 2012 ), UTAUT3 (Farooq et al., 2017 ). Source: Own elaboration.

In conclusion, despite the recent systematic review conducted by Angosto et al. ( 2020 ) on research that examined the intentions to use and implement apps in the fitness and health sector, or a recent meta-analysis of the Intention to use wearable devices in health and fitness (Gopinath et al., 2022 ), more research is needed. Regarding the need for a new review update, this is necessary for three reasons: (a) the previous review developed by Angosto et al. ( 2020 ) has some shortcomings that will be addressed in the discussion; (b) to analyse the evolution of TAM-derived models such as UTAUT, UTAUT2 or UTAUT3; and (c) the previous review was conducted just before the COVID-19 pandemic, a period in which digitalisation underwent a major evolution to respond to the needs of society. The pandemic has impacted the need to adopt modern technology to monitor, record and control physical activity for both people and sports groups (Núñez Sánchez et al., 2022 ; Ruth et al., 2022 ). As a result, the study’s aim is to perform a comprehensive systematic review that updates the number of studies that have investigated the intention to use or adopt fitness apps from 2020 to May 2023.

Review design and protocol

The Prisma in Exercise, Rehabilitation, Sports Medicine and SporTs science (PERSiST) guidelines (Ardern et al., 2022 ) based on the sports science adaptation of the Prisma 2020 statements (Page et al., 2021 ) were followed for this systematic review. The systematic review was not registered on the PROSPERO platform because, not being in the field of health, it did not meet the requirements for registering the systematic review protocol. Therefore, a prior search protocol was not established and all aspects were marked directly in the methodology of this study.

Inclusion and exclusion criteria

This systematic review includes empirical research published in peer-reviewed journals. However, grey literature was excluded, as were assessment reports, periodic reports, dissertations, abstracts and other forms of publishing. The following criteria were used to include studies in the search: (i) peer-reviewed journal articles; (ii) usage of any form of sports and fitness app; (iii) assessment of the intentions using the app through a survey and (iv) publications in English and Spanish. The following items were excluded: (i) books, book chapters, congress proceedings, or other forms of publications; (ii) qualitative approaches, theoretical research, or reviews; (iii) studies written in a language other than English or Spanish; (iv) no mobile apps were utilised in the sports environment; and (v) duplicate articles.

Search strategy

Table 1 shows the categories of terms that were utilised in the search across multiple databases. Six databases were chosen in an attempt to cover a wide variety of topics linked to this multidisciplinary study, such as sports science, health, psychology and marketing. The databases employed were Pubmed, Web of Science, PsycINFO, Scopus, ABI/Inform and SPORTDiscus. The search lasted from December 27, 2021, through May 26, 2023. The search included all years and there were no restrictions on document type or language from 2020 to the present, considering the previous work by Angosto et al. ( 2020 ).

Figure 2 illustrates the flow chart of all the points proposed by the PRISMA 2020 methodology for conducting systematic reviews (Page et al., 2021 ). The first database search found 8647 results, which were reduced to 3471 once duplicates were removed. A thorough scan of titles and abstracts was carried out by one reviewer, in addition to a full-text review of the selected studies after applying the inclusion and exclusion criteria. A second reviewer evaluated the abstracts of the publications that remained at the abstract level ( n  = 12) to check their eligibility, and there were no disagreements with the first reviewer.

figure 2

This conceptual diagram shows the protocol of the systematic review process (Page et al., 2021 ).

Assessment of methodological quality

The methodological quality analysis was tested using a rating scale measure of 20 items developed by Angosto et al. ( 2020 ) in the sport consumer research type framework where there were no intervention methods on the themes of the CONSORT checklist (Schulz et al., 2010 ). Two reviewers independently assessed each study by examining the multiple elements that make up an investigation. Each element scored one point if the study met the criterion satisfactorily or zero if the research did not meet the criterion or if the element was not applicable to this study. When disagreement emerged, the reviewers resolved this by re-examining the study until an agreement was reached. Supplementary Table S2 (see the section “Data availability”) indicated the methodological quality evaluation results for each research.

Data extraction

For data extraction, an Excel form was created that includes the following characteristics: (a) publishing year; (b) country of study , country of the institution of the first author of the study; (c) number of participants , total of the sample used in the study; (d) gender , percentage of males and females in the sample; (e) age of participants , average age or age ranges of the study sample; (f) type of Application evaluated , fitness or sport apps and their combination with other types of apps such as health or diet apps.; (g) theory used , evaluation model used in the study; (h) analyses performed , types of analysis used in the results; and (i) variables included , assessed variables included in the model proposed in the study. Supplementary Table S3 (see the “Data availability” section) showed the individual data of each study.

Analysis of the assessment of methodological quality

To assess methodological quality, the analysis of the 29 research papers reviewed in the study (Supplementary Table S2 ) found that 16 studies had the best rating of 15 points or more out of a possible 20. There have been 12 studies with an average score between 10 and 15 points, and one research had a score of <10 points (Jeong and Chung, 2022 ). It should be noted that none of the studies reviewed estimated the sample needed for the generalisability of the results, which could be attributed to the fact that all the studies selected their samples by convenience within a certain group. Furthermore, none of the research defined inclusion criteria for the sample selection. Three studies revealed which author performed each phase of the study (García-Fernández et al., 2020 ; Vinnikova et al., 2020 ; Yu et al., 2021 ), and nine studies indicated whether or not they received funding.

Summary of reported intervention outcomes

Supplementary Table S3 shows the descriptive data taken from each research. According to the findings, this issue of assessing the intention to use applications in the sports marketing industry has garnered considerable attention in recent years. A total of 29 research works were chosen, based on the studies published following the systematic review conducted by Angosto et al. ( 2020 ) that focused on the quantitative evaluation of the intention to use sports applications, using either paper-based or online surveys. The results showed that 2022 was the year with the highest number of publications ( n  = 12), while nine articles were published in 2021, there were five articles published in 2020 and three articles in 2023. The location of the research revealed that 64% of the total articles published were from Asia ( n  = 18), ~32% were from Europe ( n  = 9) and 4% were from America ( n  = 1). Among the countries with the highest number of publications, the following should be highlighted China which had the most papers, with six, followed by Spain with four articles, and Hong Kong, Taiwan, and Germany, each with three articles.

A total of 22,942 respondents were examined in the sample of studies, with a range of total size between 200 and 8840 participants, and an average of 791.1 participants per research work. With respect to the type of the sample, the vast majority considered fitness users or community members, with ten and nine articles respectively. To a limited extent, the authors used students ( n  = 6) or the general population ( n  = 2). The sociodemographic data of the sample revealed that the majority of the studies had a greater proportion of females than males ( n  = 18), with an average of 46.1% males and 53.1% females. Seven articles indicated the average age of the participants, with an average age for all 30 years old. A total of 19 articles indicated age by range, with 10 articles having a higher proportion of young people under 30 years, eight articles having a higher population between 30 and 50 years, and one article with a majority of participants over 50 years. Two articles did not indicate age in any of the above ways. Regarding the type of apps used within the sports context, they were fitness apps used in sports centres ( n  = 18), followed by sports apps ( n  = 6), four used apps that also had a health aspect and one included diet-related aspects.

Analysing the theoretical background on which the authors have based their studies, the use of the TAM model still stands out ( n  = 12), and there was an increase in the number of articles that used the UTAUT or its derivatives (UAUT = 4; UTAUT2 = 6). In addition, three studies were based on another TAM-derived model, TRAM, while one article relied on the expectation-confirmation model (ECM), or the theory of normative social behavior (TNSB), and another study encompassed several models such as the theory of consumption values (TCV) and the theory of perceived risk (TPR). When examining the link between the various constructs studied, 25 studies used structural equation analysis (SEM), while one used regression analysis and another used correlation analysis. The SEM analysis was carried out using the PLS and AMOS statistical tools.

One issue to take into account in the variables used is that intention to use (ITU) is a common variable as it is a criterion for inclusion. Although the intention to use is referred to in many different ways, the concept is the same. The results show that more than 40 variables have been directly or indirectly associated with UTI in the different articles published. The most analysed variables are those that form the basis of the TAM. PU or PE was another of the most important factors analysed together with UTI, appearing in 26 articles, followed by PEOU or EE, which was evaluated in a total of 23 articles. Among the most frequently used variables associated with the different models were Perceived Enjoyment (PEN) in eight articles, Satisfaction (SA) in five articles, Innovativeness (INN) in four studies, and Health Consciousness (HC), Optimism (OP) and Subjective Norms (SN) with three articles each.

The constructs associated with the UTAUT or UTAUT2 models have also been studied in almost all the articles that have considered these models. Among them, the use of SI stands out in eight articles, while other factors such as HA, HM, or FC have been analysed in five studies and PV in four studies. Other variables associated with the UTAUT or UTATU2 models include Self-efficacy (SE) in four articles, and PI, perceived playfulness, goal setting, attractiveness, privacy protection and barriers in one article. Other factors linked with other models that have been studied once were Insecurity, Discomfort, Need for interaction, Personal attachment, Word-of-mouth, Commitment and Quality aspects or Motivations. Appendix B shows all the variables analysed in each individual study.

Finally, considering the main results, it has been shown that, although the TAM factors (PU and PEOU) are widely studied and evidence has been found of the influence of both on UTI and PEOU on PU, there are many factors that also both directly and indirectly influence, using these two constructs as mediators of UTI. For example, PEN is a variable that eight studies have found to influence UTIs. SI and HA were other factors that also significantly influence UTI ( n  = 5 for each one). Other elements from the UTAUT/UTAUT2 models that have also been shown to influence UTI, to a lesser extent across studies, have been PV ( n  = 3), FC ( n  = 2), and HM ( n  = 3). Other aspects external to the TAM-based models that directly and significantly influence ITU were Innovativeness, Subjective Knowledge, Trust, Commitment, Perceived Playfulness, Health Consciousness, Personal Innovativeness, Autonomous Motivation, Self-efficacy, Attractiveness, Perceived Privacy Protection, Subjective Norms, Goal Setting, Risk Perception, Physical Appearance, Affiliation, Condition, Privacy Risk and Security Risk.

As for the indirect effects of the external variables considering PEOU/EE, PU/PE, or PEN as mediating variables, the influence of factors common to these three variables such as Innovativeness, Insecurity, Optimism, Perceived Attractiveness, Information Quality,and System Quality has been evidenced. Other external factors that significantly influenced both PEOU/EE and PU/PE were Subjective Knowledge, Task-Technology Fit, Accuracy, SE, PEN and Subjective Norms. While certain factors only influenced some of the variables considered, especially PU/PE, which was influenced by a greater number of external variables (Discomfort, Confirmation of Expectations, Trustworthiness, Perceived Benefits, Risk Perception, Perceived Threats), PEN only influenced Discomfort and PEOU/EE e-Lifestyles. Therefore, it was observed that there is no consensus in the scientific literature when it comes to addressing common external variables for further research in several contexts.

The aim of this systematic review was to update research that has analysed the intention to use or adopt fitness apps from 2020 to May 2023, following the study conducted by Angosto et al. ( 2020 ). It is relevant to highlight the differences between this review and the previous one by Angosto et al. ( 2020 ). For this purpose, it is important to consider the review of studies that used UTAUT or UTAUT2 developed by Venkatesh et al. ( 2016 ) as a model. In this review, the author argues the need to expand existing reference models with new exogenous, endogenous, moderating, or outcome mechanisms, as well as theorising influences at different levels. As a clear example in this line, the author himself increased the number of endogenous variables of the UAUT model including HM, PV and HA resulting in the UTAUT2 model or, in the case of Farooq et al. ( 2017 ), incorporating PI to obtain the UTAUT3 model. In addition, Davis ( 1989 ) proposed the initial TAM model by inducing external or exogenous variables in order to be able to analyse in different contexts.

Based on these aspects, the review previously carried out by Angosto et al. ( 2020 ) presents a clear limitation as it only focuses on analysing the influence of TAM or TAM2 factors, omitting the possible influences of exogenous, endogenous, or moderating variables. In this way, it should be noted that these authors do not carry out an in-depth analysis of user behaviour and its effects (both direct and indirect) that influence the ITU fitness app. On the other hand, another error is observed because the authors discriminated the variables of the UTAUT or UTAUT2 models, only focusing in the end on the studies based on TAM, TAM2, or TRAM. Therefore, when they conducted their analysis on the influence of variables, they omitted data from these studies as well. It should be noted that the UTAUT and UTAUT2 models are based on TAM, thus PE is the equivalent of PU, while EE is the equivalent of PEOU.

In view of the previous reasons, together with the period experienced by the world population as a result of the COVID-19 pandemic, it is necessary to update the previous review carried out by Angosto et al. ( 2020 ). It should be remembered that during the pandemic the population was forced to be confined to their homes. This has represented a milestone in the digitalisation of society and sports and fitness services. In fact, it can be observed that while in the review by Angosto et al. ( 2020 ), the authors identified 19 articles, from the beginning of the pandemic to the present day this review has found a total of 29 articles that met the inclusion/exclusion criteria. In short, the number of publications has more than doubled in the last three years. It is true that five research works overlapped with the prior review, which might explain why these studies were published in the press, and by assigning them a journal number, they seem published at a later date. This review emphasises the significance of this topic’s rising popularity in the fitness sector from several domains such as sociology, psychology and management (Cai et al., 2022 ).

To summarise, the results of this review and the previous review by Angosto et al. ( 2020 ) will be compared. In general, regarding the location of the studies, an increase in the number of studies conducted in Europe was observed compared to the previous review (Acikgoz et al., 2022 ; Baubonytė et al., 2021 ; Damberg, 2021 ; Ferreira et al., 2021 ; García-Fernández et al., 2020 ; Gómez-Ruiz et al., 2022 ; Pérez-Aranda et al., 2021 ; Schomakers et al., 2022 ; Yang and Koenigstorfer, 2021 ), and a decrease in the number of studies in the Americas (Won et al., 2023 ). Concerning countries, there is an exponential increase in the number of studies conducted by authors in Chinese universities and, when compared to the previous review, there is a majority of studies from South Korea.

In relation to gender, both reviews obtained similar results in which the proportion of female participants was higher than male participants in most of the studies. Although the gender of the customers or users studied was primarily female, Baubonyte et al. ( 2021 ) believe this to be rather immaterial in research that compared the intention to use new technologies based on gender. When the mean age was analysed, this review showed that the mean age of the participants was around 30 years old, while in the review by Angosto et al. ( 2020 ), this was 24 years old. Also, it should be noted that the age groups with the highest representation and the highest proportion of users were either very young (<23 years) or adult (30–50 years), while in this review most studies have a higher proportion of the population under 30 years versus adults. The reason for these results may be due to the fact that females tend to prioritise collective practice over individual practice (Vogler et al., 2008 ), and therefore there is a higher proportion of users of fitness centres or communities, while young people present fewer digital barriers when it comes to using apps than, perhaps, the adult population (Schreurs et al., 2017 ).

Depending on the type of app analysed in the different studies, variations have also been observed with respect to the previous review. The previous review emphasised that most studies considered fitness and diet apps while fitness or sports apps were the least considered. This review reports completely inverse results where the large majority of apps analysed were fitness apps followed by sport, while diet-fitness apps have been the least evaluated, with only one study. This change in trend may be clearly influenced by the context of the COVID-19 pandemic where the population forced to stay at home due to confinement felt the need to do physical exercise to be active and use leisure time in a more entertaining way. A significant proportion of the scientific literature highlights the features and functions and results of using fitness and sports apps (Kim et al., 2017 ), despite the fact that some studies have evaluated other health-related apps alongside this type of app (Aboelmaged et al., 2022 ; Chiu et al., 2021 ; Chiu and Cho, 2021 ; Zhu et al., 2023 ), or that of diet (Chiu et al., 2021 ). It is vital to highlight that the link between physical activity, fitness and health is extremely close, as is eating to live a healthy lifestyle.

Most research that has analysed technology adoption or intention to use has used the TAM model, which offers an understanding of why people embrace these technologies based on their PU and PEOU views (Márquez et al., 2020 ). However, this study found that recent research increasingly employs theories developed from the TAM, such as the TRAM model (Aboelmaged et al., 2022 ; Chiu and Cho, 2021 ), the UTAUT (Guo, 2022 ; Pérez-Aranda et al., 2021 ; Vinnikova et al., 2020 ; Wei et al. 2021 ), or the UTAUT2 model (Damberg, 2021 ; Dhiman et al., 2020 ; Ferreira-Barbosa et al., 2021 ; Kim and Lee, 2022 ; Schomakers et al., 2022 ; Yang and Koenigstorfer, 2021 ). In addition, other theories also appear in different articles such as the ECM (Chiu et al., 2021 ; Zhang and Xu 2020 ), the TNSB (Yeoh et al. 2022 ) or the TCV/TPR (Zhu et al., 2023 ). An interesting aspect to note is that, although no study based on the UTAUT3 model suggested by Farooq et al. ( 2017 ) has been found, Dhiman et al. ( 2020 ) proposed the UAUT2 model, but incorporated the PI variable which is included as a new endogenous variable within the UTAUT3.

In general, previous research on the acceptance of new technologies in the sports industry has found that PEOU (Mohammadi and Isanejad, 2018 ), or PU are the primary influences on the ‘intention to use’ (Kim et al., 2017 ). According to Venkatesh ( 2000 ), when a customer or user sees a technology to be simple to use, he or she would also regard it to be valuable. According to Cho and Kim ( 2015 ), PEOU typically has a benefit for users since it helps them to carry out activities with a more comfortable and simple method while driving the desire to continue using the app. In this regard, Liu et al. ( 2017 ) revealed that PEOU was the most important belief since the majority of fitness users thought apps were easy and simple to use when they met their expectations. Based on one research work, if the user must make an effort to learn how to use the app, this will favourably affect the consumer’s propensity to use the app (Lin et al., 2020 ). When a customer has a strong desire to use the app, the person is more likely to promote it to others (Cheng et al., 2021 ). As a result, the usage of fitness apps will be related to an increase in physical activity levels and, consequently, in health (Kim, 2022 ; Litman et al., 2015 ).

However, in spite of this more than contrasted evidence in the scientific literature, it is important to address the extent to which other variables (exogenous, endogenous, or moderating) can influence the ITU fitness app. To begin with the influence of exogenous variables, the TR model has been shown in different studies to have an external influence on TAM factors (Aboelmaged et al., 2022 ; Chen and Lin, 2018 ; Chiu and Cho, 2021 ). For example, PEOU is moderately influenced by Innovativeness and slightly influenced by Optimism and Insecurity, while PU is moderately influenced by Optimism and slightly influenced by Innovativeness, Discomfort and Insecurity (Aboelmaged et al., 2022 ; Chang et al., 2023 ; Chiu and Cho, 2021 ). Furthermore, Chiu and Cho ( 2021 ) found that both positive (Innovativeness and Optimism) and negative (Discomfort and Insecurity) factors of TR significantly influenced PEN. In another context, Raman and Aashish ( 2022 ), evaluating wearables, revealed that positive aspects of the TR positively influenced PEOU and PU, while negative aspects of TR negatively influenced these variables.

In contrast, Acikgoz et al. ( 2022 ) found a moderate influence of Innovativeness on PU and Subjective Knowledge on both PEOU and PU. Chang et al. ( 2023 ) reported a slight influence of the variable Task-Technology Fit on PEOU and PU. Other influential variables on PEOU have also been shown to be Self-efficacy (Dhiman et al. 2020 ), e-Lifestyles (García-Fernández et al., 2020 ), Perceived Attractiveness (Gómez-Ruiz et al., 2022 ; Jeong and Chung, 2022 ), Accuracy (Jeong and Chung, 2022 ), Information Quality and System Quality (Won et al., 2023 ) and Subjective Norms (Yu et al., 2021 ). As for external influential variables also in PU/PE, there are Confirmation of Expectations (Chiu et al., 2021 ), Perceived Attractiveness (Gómez-Ruiz et al., 2022 ), Accuracy and Trustworthiness (Jeong and Cheung, 2022 ), Self-efficacy, Perceived Barriers, Perceived Benefits, Risk Perception, and Perceived Threats (Wei et al., 2021 ), Information Quality and System Quality (Won et al. 2023 ) and Subjective Norms (Yu et al., 2021 ). Won et al. ( 2023 ) also found the influence of Information Quality and System Quality on PEN.

Some studies have also assessed the effects of exogenous or endogenous variables on attitudes as a moderator with ITU. Some variables that had a significant influence were PU/PE (García-Fernández et al., 2020 , Pérez-Aranda et al., 2021 ; Yu et al., 2021 ), PEOU/EE (Pérez-Aranda et al., 2021 ; Yu et al., 2021 ), PEN, Gamification and Satisfaction (Pérez-Aranda et al., 2021 ). Cai et al. ( 2022 ) found that Satisfaction acted as a moderating variable for PEOU, PU and Trust with ITU. Regarding the influence of endogenous variables that influenced ITU in addition to PEOU, PU, or PEN we found Subjective Knowledge (Acikgoz et al., 2022 ), Commitment (Chiu et al., 2021 ; Cho et al., 2020 ), PV (Damberg, 2021 ; Dhiman et al., 2020 ; Yang and Koenigstorfer, 2021 ), HA (Damberg, 2021 ; Dhiman et al., 2020 ; Ferreira et al. 2021 ; Schomakers et al. 2022 ; Yang and Koenigstorfer, 2021 ), Health Consciousness (Damberg, 2021 ), Perceived Playfulness (Damberg, 2021 ), SI (Dhiman et al., 2020 ; Ferreira et al., 2021 ; Guo, 2022 ; Vinnikova et al., 2020 ), PI (Dhiman et al., 2020 ), HM (Ferreira et al., 2021 ; Schomakers et al., 2022 ); FC (Ferreira et al., 2021 ; Yang and Koenigstorfer, 2021 ), Perceived Trust (Gómez-Ruiz et al., 2022 ), Autonomous Motivation (Guo, 2022 ), SE (Huang and Ren, 2020 ; Vinnikova et al., 2020 ), Privacy Perceived Protection (Kim and Lee, 2022), Subjective Norms (Pérez-Aranda et al., 2021 ) and Goal-setting (Vinnikova et al., 2020 ).

Particularly interesting are the studies that did not rely on TAM models or derivatives that found different variables that significantly influenced ITU. For example, Zhu et al. ( 2023 ) showed that the variables of General Health, Affiliation, Physical appearance, Condition, Perceived Risk and Security Risk influenced UTI. Yeoh et al. ( 2022 ) indicated that Outcome Expectation, Descriptive Norms and Perceived Behavioural Control influence UTI. Pérez-Aranda et al. ( 2023 ) found that attitudinal, cognitive and behavioural antecedents increase the intention to continue using a sports app. Finally, according to the influence on outcome variables, Cheng et al. ( 2021 ) observed that the ITU significantly influenced the Word-of-Mouth outcome variable. On the other hand, Ferreira et al. ( 2021 ) found that ITU influenced current use and Satisfaction, and Guo ( 2022 ) that ITU and Controlled Motivation also influenced current use. At the same time, SI, SE and Goal-setting also influenced current use (Vinnokova et al., 2020 ).

Lastly, we will discuss some evidence reported by other studies focused on the sport context, but which did not take into account fitness apps. For example, Wang et al. ( 2022 ) noted in a fitness software that SI, PE and EE significantly affected the ITU of university students. In an e-Sport game during a pandemic, Ong et al. ( 2023 ) showed that HA was the most significant factor in UTI, followed by usability, FC, SI and HM. In a similar vein, Yang et al. ( 2022 ) found that HA was the only predictor for the use of metaverse technology for basketball learning in college students. Ahn and Park ( 2023 ) showed that hedonic, user burden, pragmatic and social values were key predictors of fitness app user satisfaction. Gu et al. ( 2022 ) observed that attitudes toward exercise and the use of sports apps have a significant impact on physical activity intentions. Finally, Ferreira et al. ( 2023 ) demonstrated that the relationship between UTIs and members’ overall satisfaction with the gym is positively mediated by e-Lifestyles.

Limitations and future research

There are obvious limitations to this systematic review. The first point to mention is maybe the shorter time restriction compared to the prior review by Angosto et al. ( 2020 ). However, this is required since the COVID-19 pandemic is still active and national governments are implementing preventative measures based on the pandemic’s progress (Ferrer, 2021 ; Official State Bulletin, 2021 ). Many nations are enacting new temporary confinements, which may encourage the usage of exercise or health applications. Other potential constraints include publication bias, which occurs when journals publish research with favourable and significant results while rejecting papers with irrelevant outcomes. Another source of bias might have been the language, since there may have been publications in languages other than those specified in the inclusion criteria (English, Spanish and Portuguese). Another constraint might be the choice of search databases, because missing specific databases may result in prospective articles not being detected for inclusion in the review. A third issue is inclusion bias, which occurs when the inclusion or exclusion criteria itself prejudices against a research work. The last limitation is that the great diversity of variables analysed by the authors does not allow the generation of an adequate database that would enable a more in-depth analysis of the results through a meta-analysis beyond the TAM variables such as PEOU and PU.

Future research should try to assess sports consumers or users in other European or American contexts, with the possibility of analysing the results according to socio-demographic characteristics such as gender, age, sport, or digital experience. Age is an interesting aspect to investigate since, depending on the generation to which the person belongs, he or she will identify with new technologies to different degrees. In addition, there are variables such as those in the UTAUT model and derivatives or TR that have been more common than others, but there is still a need to increase the number of studies that use them. Other studies could take a longitudinal approach, assessing the consumer’s desire to use and actual use of the application, as well as whether or not this affects their behaviour towards a more active or healthy life.

Future lines of research relating to the evaluation of the intention to use fitness apps, or any other form of app or wearable, should examine the differences between the models in the same population using the TAM model and some of the other derived models such as the UTAUT or UTATU2. Furthermore, the proposed theoretical models should be assessed by linking them to other factors related to smartphones or other technical devices, such as attachment to the gadget, social influence for its usage, or actual use of the item, among others. Theoretical models such as the TAM, TAM2, UTAUT, UTAUT2 or UTAUT3 should be examined in various sports settings such as the usage of apps for managerial duties, sports training, or marketing/sports products.

Another key issue that has not been studied is the variation in intention to use across the different age groups of the population, since the elderly population may have a different aim than the younger population. Along similar lines, additional elements such as educational level or socioeconomic position may impact the inclination to use the fitness app or any other gadget or technology. Finally, longitudinal research might be utilised to determine how well the intention to use fitness apps matches the actual use of them.

Conclusions

This systematic review update highlights that research on the usage intention and adoption of fitness apps is a topic of interest within the digital sports marketing industry. In recent years there has been a significant increase in the number of publications, with an increasing number of European studies focusing on fitness or sports apps themselves and not associated with health or diet. In addition, the models used beyond the TAM itself are becoming more diversified, as well as the number of exogenous, endogenous and moderating variables in the different studies. Although there is no consensus on analysing the same variables in greater depth in order to generate data for a better joint analysis, there is no consensus on analysing the same variables in greater depth in order to generate data for a better joint analysis.

Finally, a practical aspect of sports organisation management is the desire that this sort of study may assist in learning the opinions of users or customers while adopting or establishing new policies with a digital transformation. This is especially important because it allows for improving the organisation’s communication in a bidirectional way. In short, the implementation of the use of apps in sports centres implies more direct and closer communication with users. In addition, physical activity and management might be monitored without eliminating travel and human interaction. For example, sports organisations make extensive use of sports digital marketing, through the use of social tools, to make the organisation more visible and to offer a more direct image and contact with current or future consumers (Angosto et al., 2022 ). However, not all users have the same social media, therefore the use of push notifications and in-app communication in a venue allows for better notification of relevant news and at a lower cost.

Furthermore, the theoretical models reviewed above identify factors that influence the ITU of technology, such as PU, PEOU, SI and FC. Sport managers can therefore use these models to identify and assess which factors are relevant in their particular context. This will help them to understand the needs and preferences of their users and to adapt their strategies accordingly.

Also, PU is a critical factor in the intention to use technology. Therefore, sports managers should assess how their users perceive the usefulness of technology in their sport context. Among the actions to be taken, they can conduct surveys, interviews or focus groups to collect data on how users feel technology can enhance their sport experience. This will allow sports managers to identify areas for improvement or additional features that can add value to the user experience. Similarly, PEOU is also an important factor in the acceptance and use of technology. In this regard, sports managers must ensure that the technology they use is easy to use and accessible to their users. This involves providing clear instructions, intuitive interfaces and adequate training to ensure that users feel comfortable using the technology.

Another variable that has been shown to influence ITU is SI. In this regard, sports managers could leverage these positive SI to promote the adoption of technology in their sports community. For example, they can collaborate with influential athletes or well-known coaches to support and promote the use of technology. They could also encourage social interaction among technology users by creating online communities or support groups. Finally, FC and perceived barriers have also been shown to influence the intention to use. Sports managers should identify and address any potential barriers that may hinder the adoption and use of technology in their sport environment. This may include a lack of technology resources, resistance to change, or privacy and security concerns. By proactively addressing these barriers, sports managers could encourage greater acceptance and use of technology.

Data availability

The datasets generated during and/or analysed during the current study are available in the Figshare repository, https://figshare.com/s/d0a13d89538847f00b67 .

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This research was funded by the Junta de Andalucía, Regional Ministry of Economic Transformation, Industry, Knowledge and Universities (grant number AT 21_00031). SA is funded by the European Union—NextGenerationEU through a postdoctoral contract with Margarita Salas.

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Salvador Angosto

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Salvador Angosto, Jerónimo García-Fernández & Moisés Grimaldi-Puyana

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Angosto, S., García-Fernández, J. & Grimaldi-Puyana, M. A systematic review of intention to use fitness apps (2020–2023). Humanit Soc Sci Commun 10 , 512 (2023). https://doi.org/10.1057/s41599-023-02011-3

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Long-term members’ use of fitness centers: a qualitative study

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Although the health benefits of physical activity are well documented, a large proportion of the population remains less active than recommended by current guidelines. Commercial fitness centers provide an opportunity to perform physical activity and exercise, but there has been little research focusing on ordinary members at commercial fitness centers. The aim of this study was therefore to explore what long-term members (> 2 years) wanted to achieve with their membership and to identify important factors that influenced them to use the fitness center as a means for physical activity.

This was a qualitative study with 21 semi-structured individual interviews of adult long-term fitness center members in Trondheim, a city in Central Norway with approximately 190,000 inhabitants. The participants had been continuous fitness center members for more than two years and were asked about their experiences using a fitness center and what they wanted to achieve with the membership. The data was analyzed thematically with the method of systematic text condensation.

The results were categorized into three main themes: “Health benefits and physical appearance”; “Accessible, safe, and comfortable to use”; and “Variety, flexibility, and support.” The participants stated that they wanted to achieve health benefits, but they also talked about physical appearance. The fitness center was mainly described as easily accessible and a comfortable place for physical activity. Some female participants emphasized the feeling of safety compared to outdoor activity. Variation in activities, making commitments, and getting support from staff and other members were factors contributing to use of the fitness center for physical activity.

Achieving desired health benefits and improving physical appearance were the main drivers for long-term members’ use of the fitness center. The fitness center was preferred due to the comfort of the facilities and the possibility to commit to specific exercise times and activities.

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The effects of physical activity to improve or maintain good health are well documented [ 1 ]. Despite public health recommendations and encouraging advice to stay physically active [ 2 , 3 ], approximately 30% of adults worldwide are physically inactive [ 4 ]. Physical activity behavior depends on a multitude of barriers and facilitators [ 5 ], such as accessibility [ 6 , 7 , 8 ], weather [ 9 ], and social support [ 10 , 11 ]. In addition, it includes many different psychological components, such as habits [ 12 , 13 ], planning [ 14 , 15 , 16 ], perceived behavioral control [ 17 ], motivation [ 18 ], physical activity identity [ 17 ], personality [ 19 ], and self-efficacy [ 16 , 17 ]. Due to the high prevalence of physical inactivity, increased levels of physical activity are a global public health priority [ 20 ].

Commercial fitness centers represent one opportunity to be physically active. The majority of fitness centers offer both group and individual activities [ 21 , 22 ]. In recent years, there has been an increase in the proportion of people who attend commercial fitness centers, with 15% of the European adult population doing so in 2013 [ 23 ]. This number is higher in some countries; for instance, it is 19.4% in Norway [ 24 ]. Statistics show a steady increase in attendance at private fitness centers in European countries; the number of members was 56.4 million at the end of 2016, which was an increase of 4.4% from the previous year [ 24 ]. Thus, fitness centers are an important arena for physical activity. However, it has been found that members would like to exercise more regularly than they do [ 25 ].

Former studies among fitness center members have focused on reasons to become and remain a member [ 25 , 26 ] and have highlighted motivational differences between fitness center and sports club members, e.g., sports club members are reported to be more motivated by competition, pleasure, and social factors and less concerned with appearance than fitness center members [ 21 , 27 , 28 ]. It has also been found that women report a slightly higher desire for wellness, a well-trained body, and weight loss than men do, while men report a desire for improved physical fitness [ 22 , 25 , 27 , 29 , 30 ].

Although a large proportion of the population are fitness center members, research on exercise behavior of members in fitness centers is limited in quantity and quality [ 31 ]. Therefore, it is important to gain in-depth knowledge of ordinary members (those who pay regular membership fees). Long-term members are an especially interesting group as they might have found a way to use the fitness center to achieve their goals for physical activity over time. However, we have not found any studies focusing exclusively on long-term members.

The aim of this study was therefore to explore what long-term members (> 2 years) wanted to achieve with their membership and to identify important factors that influenced them to use the fitness center as a means for physical activity.

This was a qualitative study with semi-structured face-to-face individual interviews conducted between March 2015 and November 2016.

In Norway, with 5.2 million inhabitants, it is estimated that there are 1079 fitness centers [ 24 ]. Within physical activity, there is also a strong tradition for participating in voluntary organizations in Norway, where sports clubs constitute the largest proportion [ 32 ].

This study took place among members of different fitness centers in Trondheim, a city in Central Norway with approximately 190,000 inhabitants, within the 3 T-Fitness Center chain ( www.3t.no ). 3 T established its first fitness center in 1985, and the chain is now the largest fitness center chain in Central Norway, with 16 fitness centers and approximately 40,000 members. During data collection, the fitness center chain had a total of 12 fitness centers, with eight of them located in Trondheim. A membership in this fitness center chain has a cost of 350–550 NOK (approximately 40–60 EUR) per month. To become a member, one has to sign a one-year contract; thereafter, one can terminate the contract one month after giving notice. The centers in this chain have a diversity of training opportunities, with a main workout area that primarily consists of free weights, weight machines, rowing machines, stationary exercise bikes, elliptical trainers, and treadmills. Nearly all centers offer group classes, personal trainers, saunas, and member lounges with simple café services. Some centers offer squash, childcare, and physical therapy. The largest center also has a swimming pool and a wellness area.

Participants

The inclusion criteria for this study required that each participant was older than 18 years and had been a paying member for more than two years continuously (to avoid the large proportion terminating their membership after the obligatory one-year contract) at one of the eight 3T fitness centers in Trondheim. We sought a sample with diversity in gender, age, frequency of visits, and types of services used, ranging from those included in the membership to services with extra cost such as hiring a personal trainer.

The first step in recruiting participants consisted of randomly selecting from the membership register 24 members who met the inclusion criteria. Each of these prospects received a letter or an email with information about the study and a request to participate. The message also stated that they would be contacted by phone after two weeks if they did not respond before that time. Of these 24, 16 responded positively and were interviewed. However, none of these participants were under the age of 27, nor had they used additional services with extra cost. Therefore, eight additional prospects were identified in the member register or by employees at the fitness center. They were contacted as described above, resulting in two more participants who were in their early 20s and three participants (age range 30–57 years) who had used services with extra cost (personal trainer, physiotherapist, and / or nutrition supervisor).

Data collection

The interviews were conducted by the first author at a place chosen by the participants and lasted from 32 to 62 min (average 48 min). The interviews were audiotaped and transcribed verbatim.

An interview guide with open-ended questions was developed by the first author, based on former literature about fitness center use, goal achievement, motivation, and the patient experiences questionnaire (PEQ) [ 26 , 29 , 31 , 33 – 35 ], as well as discussions among the authors and a research group three of the authors belong to. The four main questions were: “Can you tell me about your experiences of being a member at the fitness center?”, “What contributes to your use of the fitness center?”, “What do you want to achieve with the membership?”, and “Is there anything the fitness center can do to make it easier for you to achieve what you want with the membership?”. The following topics were introduced if the participant did not spontaneously talk about them: description of your own physical activity behavior; what affects your use of the fitness center (facilities, opening hours, activities available, social interactions, family, friends, and support and presence of staff); and reasons why you achieve / do not achieve what you want with the membership.

Data analysis

The data was analyzed thematically with the method of systematic text condensation (STC) by Malterud, which is inspired by Giorgi’s psychological phenomenological method [ 36 ]. An illustration of the STC process and how the participant responses were coded and categorized is given in Table  1 . The STC process is an iterative four-step method suitable for descriptive cross-case analysis of qualitative data. The method was chosen because it is well suited to present participants’ experiences, rather than the possible underlying opinions of what was told [ 36 ]. All interviews were held in Norwegian and the material was kept in its original language throughout the analysis. The data analysis was conducted by the first author in cooperation with the co-authors and discussed twice in an established research group.

In the first step of the analysis, the first author and the co-authors read the transcripts from a bird’s-eye perspective to identify preliminary themes. In the second step, meaning units (text segments) relevant to the aim of the study were identified by the first author, then coded and sorted into code groups based on the preliminary themes. The second step was done repeatedly, with several meetings and discussions among co-authors and the research group. MindManager [ 37 ] was used as a systematization tool in this part of the analysis. In the third step, a condensed description of the citations in each code group was made using the participants’ original phrases. Finally, in the fourth step, the descriptions were rephrased into analytical text.

The first sequence of analysis included the first thirteen interviews and was performed to identify areas that needed to be explored in more detail in further interviews. This was done because analyzing the data stepwise may contribute to systematic improvement of data collection, facilitate reflection, and reduce the number of participants needed [ 36 , 38 ]. The four steps of the STC were performed repeatedly in both the preliminary stages and the final analysis, leading to several changes and modifications before the final themes were agreed upon.

The analysis was validated by continuously checking the findings against the transcripts, especially after the final analysis. The first author identified illustrative citations and discussed them with the co-authors to choose the ones that best illustrated the themes. These were translated from Norwegian to English by the first author and checked by the other authors.

A total of 21 long-term members (11 females and 10 males) from eight different fitness centers were interviewed (Table  2 ). They had been members for 2–20 years and their average age was 43 years (range 20–71 years).

What long-term members wanted to achieve with their membership is described in the theme “Health benefits and physical appearance.” Their experiences with factors affecting their use of the fitness center as a means for physical activity were categorized into the themes “Accessible, safe, and comfortable to use” and “Variety, flexibility, and support.”

Health benefits and physical appearance

The long-term members said that they used the fitness center to achieve desired health benefits. The main examples of health benefits were more energy, improved mood and sleep, reduced stress, better well-being, or feeling happier after the workout. Some participants with health complaints said that use of the fitness center was a necessity for their daily function, e.g., to prevent deterioration of their health complaint, and as an aid in pain management.

Yes, I feel the positive effects exercise have for me, in relation to both energy and my mood. And my anxiety, it affects that a lot. I have had years where I only have been sitting indoors, without getting out of the house. (Female, 30–49 years, member for 8 years).

However, during the interviews some long-term members mentioned that they wanted to achieve a better look. Physical appearance was seldom directly talked about as a reason. The participants rather mentioned it in passing, e.g., adding it after having talked about another reason, followed by a joke or laughter. The things they said that concerned physical appearance included a fear of becoming overweight, wanting to get into the clothes they had worn before, reducing abdominal size, and becoming more muscular.

I have never been concerned about how I look and exercise solely in order to be able to continue to work and avoid a new knee replacement. But I should perhaps have reduced this slightly [laughs and pats the stomach]. (Male, 50–71 years, member for 4 years).

Male participants, in particular younger males, talked more about wanting to achieve a muscular body and becoming stronger, while female participants talked more about weight loss. When asked about the reason for their focus on physical appearance in relation to the use of the fitness center, some female participants talked about increased emphasis in society on being thinner and fit.

It feels like we should have been a little leaner, yes actually a little better at everything. If you do not exercise and stay healthy and slim, you are almost a bit questionable. According to everything that is communicated from the fitness center and health authorities (short pause). I do not like that it affects me so much. (Female, 30–49 years, member for 6 years).

Accessible, safe, and comfortable to use

The fitness center was primarily described as a comfortable place to be physically active. It was common to talk about physical activity in the fitness center as easier than being active outdoors. Due to the indoor comfort, avoiding bad weather and winter darkness, they said the fitness center made it easier to motivate themselves to be physically active. Living or working near the fitness center, ample opportunities for parking, and public transport were also given as reasons. Some female participants emphasized the importance of increased security when using the fitness center for physical activity compared to exercising outdoors on their own.

I feel safe when I visit the fitness center and it is cozy getting inside to the reception area with those flames from the fireplace and the friendly staff in the reception. I am afraid of the dark and yes, I am a little afraid of being assaulted by someone when running outside. (Female, 20–29 years, member for 3 years).

Even though some participants talked about how they enjoyed using the fitness center for physical activity, they described different challenges and barriers that hindered them in using the fitness center as much as they wanted, e.g., too little time, no childcare, and low motivation to get out of the house. Participants with children living at home especially expressed difficulties finding time and energy. It was said that having commitments such as appointments with others, pre-booked activities, or payment of no-show fees could help them to prioritize physical activity at the fitness center.

It is a bit odd because I like it when I am at the fitness center, but sometimes or actually quite often, it is hard to get out of the door at home. It is very positive that one must pay if one does not meet for (pre-booked) group classes, because then I have to go. (Female 20–29 years, member for 2 years).

Payment of membership fees and fees for working with personal trainers were said to affect use of the fitness center for some long-term members; typically, they wanted to use the services they had paid for. However, most participants stated that the fee was not something they thought of. One participant who was receiving disability benefits talked about the fitness center as an affordable option for exercise and as the only possibility to be regularly physically active.

It is cheap for me to be a member of the fitness center and it means a lot to me, since I have limited money available. I do not have much money to spend when all expenses are paid, but it is working fine for me to pay a small amount each month [to be a member of the fitness center]. (Female, 50–71 years, member for 4 years).

Some of the long-term members said that they valued the fitness center as a social meeting place where they could spend time with friends, family, and colleagues and make new acquaintances. This was facilitated by a friendly atmosphere at the fitness center and services like the opportunity to buy a cup of coffee and sit down for a chat.

I appreciate having the opportunity to socialize with my friend and that we can sit down, relax, and have a chat after the workout. In fact, I always work out with someone. It's social. (Male, 50–71 years, member for 9 years).

Variety, flexibility, and support

Variety, with both group classes and various possibilities for self-training, was said by some long-term members to be important with regard to regular use of the fitness center for physical activity. Those using mainly group classes or self-training had different explanations for their use of the fitness center facilities as a means for physical activity.

A typical argument given for participating in group classes was as a help to exercise more vigorously compared to self-training. Some also said that they preferred group classes because they were time limited and followed a fixed structure. Furthermore, some spoke about the boost they got from the atmosphere and enthusiasm in the group classes. This was also mentioned as a reason for going to the fitness center in general, since it required less self-motivation. Other things mentioned were enjoyable experiences, being in a group with others, mastering a new step in a choreography, or a pleasant conversation.

As an example, if I had chosen a fitness center without classes, instructors, or those types of facilities, I would have needed the inner motivation for exercising, and to be honest — that is not strong enough. I need something and someone to motivate me. (Male, 30–49 years, member for 5 years).

The reasons for preferring self-training were described somewhat differently from group classes. The arguments given for self-training were flexibility, an all-in-one-place access to equipment, exercise at their own pace, and opportunities for targeted exercise in both strength and endurance. On the other hand, participants who did not perform self-training regularly spoke about challenges to implement it, e.g., because they found it boring, a duty, and not enjoyable.

I have got an exercise program; everything else is too hard, group classes and such. I take my program at my own pace and it strengthens me. It is a bit similar to what I do with the physiotherapist, but here I do not have to see so many sick people. (Female, 50–71 years, member for 4 years).

Some long-term members spoke positively about the help and the individual instructions they received from staff in the main workout area. It had helped them to understand what to do and how to do it when they used the fitness center. The staff were generally described as friendly, helpful, and knowledgeable if the members made appointments, but some perceived them as not very available for questions and help during workouts. Some participants had also used personal trainers and found it helpful for recognizing and understanding their physical capacity and getting a more efficient workout. Personal training was also described by some as helpful when implementing more regular use of the fitness center.

Yes, I thought I was exercising. However, I realized with guidance from a personal trainer that I previously had been far from being able to call it exercise. So, everyone should try a personal trainer to really understand what one should do and how. (Female, 30–49 years, member for 15 years).

The participants stated that they wanted to achieve health benefits, but they also talked about physical appearance. The fitness center was mainly described as easily accessible and a comfortable place for physical activity. Some female participants emphasized the feeling of safety compared to outdoor activity. Variation in activities, making commitments, and getting support from staff and other members were factors contributing to using the fitness center for physical activity.

There was a duality in what the long-term members wanted to achieve, between health benefits and appearance. The participants talked about the health benefits of physical activity as a main reason to use the fitness center. A survey has also found that members of fitness centers in Norway report they exercise to become fit rather than to gain a better-looking body [ 27 ], and the author suggested that it might feel better to say they exercise for fitness rather than for appearance. Similarly, in our study, appearance was mentioned as an additional reason after talking about health benefits. However, findings in another survey among fitness club members showed that seeing physical change as “becoming stronger” or “being able to see improvement in the way I look” were the main reasons for being physically active across age and gender [ 29 ].

This raises a question on whether long-term members of fitness centers are more occupied with their appearance than others doing physical activity in other settings. One study found this to be the case, with members of sports clubs being less concerned with appearance than fitness center members [ 27 ]. Similarly, a study on college students reported that those who engaged in exercise (e.g., aerobics, cycling, weight training) were more focused on appearance than those engaging in sports (e.g., tennis, basketball, soccer) [ 28 ]. It may be positive for fitness center members to focus on looks if it leads to a physically active lifestyle. However, for some, the focus on appearance might lead to a negative attitude towards oneself and make one exercise excessively [ 39 , 40 , 41 ]. It is therefore reasonable to question whether fitness centers should focus on appearance when marketing and promoting activities at the centers. In Norway, the main enterprise federation for fitness centers encourages them to be aware of the risk of excessive exercise in relation to disordered eating among their members.

Some of the participants said that they did not visit the fitness center as often as they wanted. A Danish report also found that most members of fitness centers would have liked to work out more frequently than they did [ 25 ]. An interesting finding in our study was that having committed to exercise through actions like pre-booking an activity, making a binding agreement with others, or making a payment was said to be the pressure they needed to visit the fitness center. This has not previously been reported, although it has been shown that making personal commitments using commitment devices with rewards or punishments for success or failure has been beneficial for behavioral changes [ 42 , 43 ]. This can indicate that binding agreements such as pre-booking of activities, no-show fees, appointments, and even payments can be tested by the fitness centers to see if they promote increased use and consequently more regular physical activity among the members.

According to some participants in the present study, an important motivational factor for using the fitness center was the opportunity for social interaction. Participants reported benefits from social support from employees, group classes, and other members, but also from the possibility to be in a social setting. A review also concluded social support to be positively associated with levels of physical activity among adolescents [ 10 ], and another review on qualitative studies also found that development and maintenance of social support networks were important for participation in sport and physical activity [ 11 ]. Even if these reviews focus on physical activity in general, together with this study it is reasonable to hypothesize that fitness centers can help members to increase their motivation to use the fitness center if they facilitate more opportunities for social interaction. Moreover, a conscientious use of both social interaction and binding agreements might be even more helpful and motivating for some members.

As expected, all participants appreciated that the fitness center was easily accessible, safe, and a comfortable place to be, especially during the fall and winter months. It has also been suggested in a review that levels of physical activity vary with seasons [ 9 ]. On the other hand, one study found that weather showed a weaker relationship with physical activity than did accessibility [ 6 ]. Similarly, another study found that weather had modest effects on physical activity [ 44 ]. In general, easily accessible opportunities for physical activity are positively correlated with the level of activity [ 6 , 7 , 8 ]. Thus, in a public health perspective it is important to emphasize that having safe and easily accessible fitness centers might be a driver for more regularly physical activity in the population.

The factors identified in this study are based on experiences from long-term members who have chosen to continue as members for an extended period and naturally are quite satisfied with the fitness center as an arena for physical activity. However, the factors identified are most likely quite similar for all members, regardless of membership duration [ 26 ]. It is also possible that the identified factors are important factors generally to maintain physical activity over time.

Strengths and limitations

A strength in the study is that it is the first to investigate what long-term members want to achieve with their membership and factors affecting their use of the fitness center as a means for physical activity. Another strength lies in the diversity of the sample. A limitation was that the study was done in a restricted geographical area and in only one fitness center chain. It also focused on long-term members and thus not those who for various reasons have terminated their membership. Moreover, it is possible that invited members who did not want to participate in the study are different from those who enrolled. Furthermore, younger participants were few in number. Younger participants might have had different experiences due to having other motives for participation in physical activity [ 45 ]. Given the similarity with findings in other studies on maintaining physical activity [ 26 ], it is not likely that the lack of younger participants has influenced the findings in the current study.

We consider it as a strength that the authors, who all took part in the analysis, have different backgrounds and experiences. Having researchers with other backgrounds, using a theory-driven approach, or doing member checking by inviting the participants to comment on the results could have produced other understandings and explanations.

At the time of the completion of the study, the first author worked in the administration of the fitness center chain, which might have influenced the research process. This was duly handled by having the co-authors participate in all steps of the research process, paying attention to the possibility of biases.

This study indicates that the main drivers for long-term members’ use of a fitness center is to achieve desired health benefits and improve physical appearance. The prominent factors for using the fitness center were the comforts of the facilities and the ability to commit to exercise through fixed times for group activities, bookings, payments, and training agreements. Female members also valued the fitness center as a safe place for physical activity. Still, being physically active to the degree one wants is challenging, even for some long-term members.

From a public health perspective, the findings in this study point to commitment and having access to safe and easily accessible arenas for physical activity as being possible drivers for physical activity maintenance.

Further research is required to quantify the knowledge from this study. Doing a questionnaire-based survey with a randomly selected sample of fitness center users is recommended.

Abbreviations

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Acknowledgements

We thank all the participants, Hilde Thommesen Holck (CEO of 3 T-Fitness Center), Tor Albert Thommesen (Chairman of the Board of 3 T-Fitness Center), The Research Council of Norway, and 3 T-Fitness Center for involvement in and contributions to the project.

This research was funded 50/50 by 3 T-Fitness Center and The Research Council of Norway with grant number 239657.

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In the anonymized transcripts it is possible to identify the participants, and restrictions therefore apply to the availability of these data. Due to regulations of The Regional Committee for Medical and Health Research Ethics, we have to secure the anonymity of the participants. Parts of the anonymized transcripts are available from the corresponding author on reasonable request.

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LR and AS designed and planned the project. LR collected data, performed data analysis, and drafted and completed the manuscript. AS participated in every part of the data analysis. AS, TILN, and THN participated in analysis meetings and commented on the manuscript. All authors read and approved the final version to be published.

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The study was submitted to The Regional Committee for Medical and Health Research Ethics in Central Norway (2014/1870 REK Midt) and they assessed it as not being health research and therefore not needing their approval. The study was approved by NSD — Norwegian Centre for Research Data (NSD 40604/3/SSA).

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Riseth, L., Nøst, T.H., Nilsen, T.I.L. et al. Long-term members’ use of fitness centers: a qualitative study. BMC Sports Sci Med Rehabil 11 , 2 (2019). https://doi.org/10.1186/s13102-019-0114-z

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Cozy Cardio is the concept of creating a comfortable and pleasing space to exercise in private on your own time.

As you settle into a cozy nook with your favorite beverage, mood lighting and tunes or your favorite show,  you might not expect your next move to be a workout. Yet, according to the newest fitness trend, this setting might just be the perfect spot for your exercise routine.

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According to Michael, the challenge lies in reshaping the perception of exercise to cultivate a more active lifestyle. “People often feel daunted by rigorous routines or the time commitment,” he observes. “Integrating movement into daily habits is a subtle yet effective way to foster a more active lifestyle.”

Michael, reflecting on his own challenges of inactivity during the COVID-19 pandemic, shared his experience. His decision to adopt a dog compelled him to establish a new routine: daily walks. "Now, it’s second nature,” he admits.

Starting a new health regimen is one aspect; however, planning for inevitable setbacks along the way is equally critical, according to Michael. He says practicing a new habit for the initial three months helps cement new behaviors. “Write yourself an exercise prescription; it’s a script with endless refills,” he says.

He also advocates for personalized approaches to exercise by accommodating individual preferences, be it in a gym, the outdoors or the comfort of one’s home. The concept of Cozy Cardio emphasizes the need to counteract a sedentary society. Encouraging early action, Michael stresses the importance of not waiting for a health crisis to prompt change.

“Prioritize your health and take proactive steps now,” he advises. “Embracing movement and prioritizing personal well-being are essential for a sustainable, healthier lifestyle.” ■

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The Online Home for Strength Sports

Anthropology 101: A Cultural Anthropologist Walks into a Gym

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Editors note: Katie Hejtmanek, Ph.D. is a cultural anthropologist conducting research on the culture of strength sports in the United States. This is the first of an in-depth series introducing readers to her research and preliminary findings. All observations, data, and photos come from her own research.

If you’re a fan of strength sports and want to look at their growth from a cultural, anthropological, and/or analytical perspective, we highly recommend this series. The articles go in-depth on Dr. Hejtmanek’s work, and they’re well worth your time.

Workout Notebook

Have you heard this one? A new play on an old joke. That’s what we cultural anthropologists do: We make the familiar strange and the strange familiar. We look for meaning in the mundane, we ask questions about everyday life, and we seek to understand why people do what they do. We analyze human behavior, not to understand individual motivations, but large, cultural patterns.

Unlike psychologists, we don’t end our analysis on why individuals do what they do, the “in here” reasons for individual behavior. No, we keep digging. We investigate what “out there” in the world supports what people (more than one) are doing, what challenges these behaviors, and why people are doing this now, as opposed to, say, before. We are interested in cultural phenomena, the shared meanings, ideas, beliefs, and behaviors shared by a group of people, and taught and learned by members of a group. 

(Although “culture” is still hotly debated in the field of anthropology, this is a composite of many of the definitions.)

Situpsball

Sometimes these beliefs, ideals, and meanings are taught explicitly – mission statements, official pronouncements of a company’s “culture.” However, if you’ve taken Anthropology 101, you’d know that most of the stuff of culture is taught implicitly; it’s tacit. A cultural anthropologist’s ears perk up when she hears someone say something is “common sense,” or “natural.” Pay dirt. “Common sense” or “natural” are culturally specific beliefs and behaviors masquerading as human universals. If you decide to keep reading (here or any of my articles), you’ll see what I mean.

I am interested in the explicit culture of strength sports – how athletes talk about their sport and their motivations, how organizations brand themselves, what people are actually doing (weightlifting, powerlifting, CrossFit, etc.) , who is joining, where did they come from, and all of the other ways that strength sports and athletes make their voices heard.

For example, Union Square CrossFit and Reebok CrossFit 5th Ave each has a specific page dedicated to its Culture. Something new is always happening, and a new friend is on the other side of the platform (they claim). I wonder if this is actually true…. And it’s the job of the anthropologist to find out!

Teamwork

I am also interested in the implicit, the tacit. I tack between individuals and their expressed motivations for joining, say, a CrossFit box and the larger social forces in America that support this endeavor . For example, it is a new phenomenon that women are seeking out fitness activities that actively promote muscular bodies. We’ve been taught that the ideal female body is skinny. It is not “natural” or universal to idealize a skinny female body, rather it has been an American cultural ideal.

But as I read on one of my female student’s t-shirt recently: Strong is the New Skinny (also the title of book written by Jennifer Cohen and Stacey Colino, Harmony Books, 2014). And this is not just a pithy saying. Women are joining powerlifting groups, CrossFit boxes, and weightlifting clubs in droves. It is the job of the anthropologist to find out why!

What happened? How did strong become the new skinny? What are the larger forces at play to encourage this cultural shift? How do women talk about it, besides by wearing a t-shirt? Why do we have shirts that state this? As a cultural anthropologist, it’s my job to find out.

SquattingKatie

How do I find out? Well, I conduct research. We call it ethnography. Anthropologists live with a group of people and learn the cultural norms, beliefs, and meanings of the group. We listen to what people say about their culture (the emic perspective). We also notice what people don’t talk about, what is assumed, and the differences between what people say they do or believe and what they actually do or say (for example, is something new always happening!?). We then analyze what is happening, finding patterns in speech and behavior, and we interpret what the culture is about.

Kettlebell Swing

I treat strength sports in America as its own “tribe.” I join them; I hang out in gyms, boxes, and sports clubs. I talk to people, I ask them questions, and I listen for how they talk, what they talk about, and I watch what they do. I observe the athletes, trainers, coaches, spectators, family members, and enthusiasts. I don’t do this for a weekend event, or to ferret out a story in the journalistic sense. Rather, I am interested in the everyday, the mundane of strength sports.

And I am interested not just in what people say they do, but what they actually do . I am interested in making the strangeness of strength sports mundane and in making the mundane of strength sports strange. The point is to take the time to systematically analyze this unique cultural phenomenon – the surge in strength sports in the United States – and to share the findings with you. That’s what happens when a cultural anthropologist walks into a gym.

Editors note: This article is an op-ed. The views expressed herein are the authors and don’t necessarily reflect the views of BarBend. Claims, assertions, opinions, and quotes have been sourced exclusively by the author.

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About Katie Rose Hejtmanek, PhD

I'm a cultural anthropologist and professor of anthropology conducting research on strength sports in the US. Follow me on Instagram and Twitter @maxesandprs.

View All Articles

BarBend is an independent website. The views expressed on this site may come from individual contributors and do not necessarily reflect the view of BarBend or any other organization. BarBend is the Official Media Partner of USA Weightlifting.

High levels of niacin linked to heart disease, new research suggests

High levels of niacin, an essential B vitamin, may raise the risk of heart disease by triggering inflammation and damaging blood vessels, according to new research.

The report, published Monday in Nature Medicine, revealed a previously unknown risk from excessive amounts of the vitamin, which is found in many foods, including meat, fish, nuts, and fortified cereals and breads.

The recommended daily allowance of niacin for men is 16 milligrams per day and for women who are not pregnant is 14 milligrams per day.

About 1 in 4 Americans has higher than the recommended level of niacin , said the study’s senior author, Dr. Stanley Hazen, chair of cardiovascular and metabolic sciences at the Cleveland Clinic’s Lerner Research Institute and co-section head of preventive cardiology at the Heart, Vascular and Thoracic Institute.

The researchers currently don’t know where to draw the line between healthy and unhealthy amounts of niacin, although that may be determined with future research.

"The average person should avoid niacin supplements now that we have reason to believe that taking too much niacin can potentially lead to an increased risk of developing cardiovascular disease,” Hazen said.

Currently, Americans get plenty of niacin from their diet since flour, grains and cereals have been fortified with niacin since the 1940s after scientists discovered that very low levels of the nutrient could lead to a potentially fatal condition called pellagra, Hazen said.

Prior to the development of cholesterol-lowering statins , niacin supplements were once even prescribed by doctors to improve cholesterol levels.

To search for unknown risk factors for cardiovascular disease, Hazen and his colleagues designed a multipart study that included an analysis of fasting blood samples from 1,162 patients who had come into a cardiology center to be evaluated for heart disease. The researchers were looking for common markers, or signs, in the patients’ blood that might reveal new risk factors. 

The research resulted in the discovery of a substance in some of the blood samples that is only made when there is excess niacin. 

Meat in grocery store

That finding led to two additional “validation” studies, which included data from a total of 3,163 adults who either had heart disease or were suspected of having it. The two investigations, one in the U.S. and one in Europe, showed that the niacin breakdown product, 4PY, predicted participants’ future risk of heart attack, stroke and death.

The final part of the study involved experiments in mice. When the rodents were injected with 4PY, inflammation increased in their blood vessels. 

The results are “fascinating” and “important,” said Dr. Robert Rosenson, director of metabolism and lipids for the Mount Sinai Health System in New York City.

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The newly detected pathway to heart disease might lead to the discovery of a medication that could reduce blood vessel inflammation and decrease the likelihood of major cardiovascular events, he added.

Rosenson hopes that the food industry will take note and “stop using so much niacin in products like bread. This is a case where too much of a good thing can be a bad thing.”

The new information could influence dietary recommendations for niacin, said Rosenson, who was not involved with the Cleveland Clinic research.

Scientists have known for decades that a person’s cholesterol level could be a major driver of heart disease, said Dr. Amanda Doran, an assistant professor of medicine in the division of cardiovascular medicine at the Vanderbilt University Medical Center.

Even when patients’ cholesterol levels were brought down, some continued to have a high risk of heart attacks and stroke, Doran said, adding that a 2017 trial suggested that the increased risk might be related to blood vessel inflammation.

Doran was surprised to learn that niacin could be involved in driving up the risk of heart disease.

“I don’t think anyone would have predicted that niacin would have been pro-inflammatory,” she said. “This is a powerful study because it combines a variety of techniques: clinical data, genetic data and mouse data.”

Finding the new pathway may allow future researchers to discover ways to reduce blood vessel inflammation, Doran said.

“It’s very exciting and promising,” she said.

Linda Carroll is a regular health contributor to NBC News. She is coauthor of "The Concussion Crisis: Anatomy of a Silent Epidemic" and "Out of the Clouds: The Unlikely Horseman and the Unwanted Colt Who Conquered the Sport of Kings." 

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How Red Wine Lost Its Health Halo

For a glorious decade or two, the drink was lauded as good for the heart. What happened?

A close-up overhead image of a glass of red wine on a white surface.

By Alice Callahan

In a 1991 segment of “ 60 Minutes ,” the CBS correspondent Morley Safer asked how it could be that the French enjoyed high-fat foods like pâté, butter and triple crème Brie, yet had lower rates of heart disease than people in the United States.

“The answer to the riddle, the explanation of the paradox, may lie in this inviting glass,” Mr. Safer said, raising a glass of red wine to viewers.

Doctors believed, Mr. Safer said, that wine had “a flushing effect” that prevented blood clot-forming cells from clinging to artery walls. This, according to a French researcher who was featured in the segment, could reduce the risk of a blockage and, therefore, the risk of a heart attack.

At the time, several studies had supported this idea , said Tim Stockwell, an epidemiologist at the Canadian Institute for Substance Use Research. And researchers were finding that the Mediterranean diet , which has traditionally encouraged a glass or two of red wine with meals, was a heart-healthy way of eating, he added.

But it wasn’t until the “60 Minutes” segment that the idea of red wine as a virtuous health drink went “viral,” he said.

Within a year after the show aired, red wine sales in the United States jumped 40 percent .

It would take decades for the glow of wine’s health halo to fade.

How our understanding of alcohol and health has evolved

The possibility that a glass or two of red wine could benefit the heart was “a lovely idea” that researchers “embraced,” Dr. Stockwell said. It fit in with the larger body of evidence in the 1990s that linked alcohol to good health.

In one 1997 study that tracked 490,000 adults in the United States for nine years, for example, researchers found that those who reported having at least one alcoholic drink per day were 30 to 40 percent less likely to die from cardiovascular disease than those who didn’t drink. They were also about 20 percent less likely to die from any cause.

By the year 2000, hundreds of studies had reached similar conclusions, Dr. Stockwell said. “I thought the science was in,” he said.

But some researchers had been pointing out problems with these kinds of studies since the 1980s, and questioning if the alcohol was responsible for the benefits they saw.

Perhaps moderate drinkers were healthier than non-drinkers, they said, because they were more likely to be educated , wealthy and physically active, and more likely to have health insurance and eat more vegetables. Or maybe, these researchers added, it was because many of the “non-drinkers” in the studies were actually ex-drinkers who had quit because they had developed health issues.

Kaye Middleton Fillmore, a researcher at the University of California, San Francisco, was among those urging more scrutiny of the research. “It is incumbent on the scientific community to assess this evidence carefully,” she wrote in an editorial published in 2000 .

In 2001, Dr. Fillmore persuaded Dr. Stockwell and other scientists to help her sift through the previous studies and reanalyze them in ways that could account for some of these biases.

“I’ll work with you on this,” Dr. Stockwell remembered telling Dr. Fillmore, who died in 2013. But “I was really skeptical of the whole thing,” he said.

As it turned out, the team found a surprising result: In their new analysis, the previously observed benefits of moderate drinking had vanished. Their findings, published in 2006 , made headlines for contradicting the prevailing wisdom: “ Study Puts a Cork in Belief That a Little Wine Helps the Heart ,” The Los Angeles Times reported.

“It upset an awful lot of people,” Dr. Stockwell said. “The alcohol industry took huge steps and spent a lot of money to counteract this rather awkward message that was coming out,” he added. Within months, an industry-funded group had organized a symposium to debate the research, and they invited Dr. Fillmore.

In notes Dr. Stockwell saved, Dr. Fillmore wrote that the discussion was “hot and heavy, such that I felt like I needed to get my shoe off, banging it on the table.”

And when two conference organizers published a summary of the symposium that said that “the consensus of the conference” was that moderate alcohol consumption was associated with better health, Dr. Stockwell said that Dr. Fillmore “was furious” that her views weren’t represented .

Since then, many more studies, including one Dr. Stockwell and his colleagues published in 2023 , have confirmed that alcohol is not the health drink it was once believed to be.

In 2022, researchers reported graver news : Not only was there no cardiovascular benefit to drinking alcohol, it could even increase the risk of heart issues, said Dr. Leslie Cho, a cardiologist at the Cleveland Clinic.

Today, more and more research shows that even one drink per day can increase your chances of developing conditions like high blood pressure and an irregular heart rhythm , both of which can lead to stroke, heart failure or other health consequences, she said.

And alcohol’s links to cancer are clear — something the World Health Organization has been stating since 1988 .

That’s a very different message from the one patients might have heard from their doctors for years, Dr. Cho acknowledged. But the consensus has shifted.

No amount of alcohol is safe , the W.H.O. and other health agencies have said, regardless of whether you’re drinking wine, beer or liquor.

So, is wine out?

When counseling her cancer patients, Jennifer L. Hay, a behavioral scientist and health psychologist at Memorial Sloan Kettering Cancer Center in New York City, said that many are “absolutely shocked” to learn that alcohol, including wine, is a carcinogen. In a 2023 study , researchers surveyed nearly 4,000 U.S. adults and found that only 20 percent were aware that wine could cause cancer — compared with 25 percent who knew that beer could, and 31 percent who knew that liquor could.

Dr. Cho's cardiology patients are often surprised when she suggests that they should cut back on alcohol, including wine. “They’re like, ‘What? I thought it was supposed to protect against heart disease,’” she said.

Red wine does contain compounds called polyphenols, some of which can have antioxidant and anti-inflammatory properties.

But no studies, including decades of research on one polyphenol called resveratrol, have definitively linked the amounts that you get from red wine to good health, Dr. Cho said. And there’s no good evidence that wine is less harmful than other types of alcohol, she added.

“That can be really hard to hear,” Dr. Hay acknowledged.

Whenever she tells people that she studies the risks of alcohol, “a pall falls over the room,” she said.

But Dr. Hay and other researchers are not suggesting a “prohibition” on alcohol, Dr. Hay added. She just wants people to be informed about the risks.

And for most people, it’s fine to enjoy a glass of wine every now and then, Dr. Cho said.

But it doesn’t help your heart, she said. “It’s just time to let go of that belief.”

Alice Callahan is a Times reporter covering nutrition and health. She has a Ph.D. in nutrition from the University of California, Davis. More about Alice Callahan

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40 facts about elektrostal.

Lanette Mayes

Lanette Mayes

Modified & Updated: 04 Feb 2024

Published: 22 Jul 2023

Modified: 04 Feb 2024

40-facts-about-elektrostal

Elektrostal is a vibrant city located in the Moscow Oblast region of Russia. With a rich history, stunning architecture, and a thriving community, Elektrostal is a city that has much to offer. Whether you are a history buff, nature enthusiast, or simply curious about different cultures, Elektrostal is sure to captivate you.

This article will provide you with 40 fascinating facts about Elektrostal, giving you a better understanding of why this city is worth exploring. From its origins as an industrial hub to its modern-day charm, we will delve into the various aspects that make Elektrostal a unique and must-visit destination.

So, join us as we uncover the hidden treasures of Elektrostal and discover what makes this city a true gem in the heart of Russia.

Known as the “Motor City of Russia.”

Elektrostal, a city located in the Moscow Oblast region of Russia, earned the nickname “Motor City” due to its significant involvement in the automotive industry.

Home to the Elektrostal Metallurgical Plant.

Elektrostal is renowned for its metallurgical plant, which has been producing high-quality steel and alloys since its establishment in 1916.

Boasts a rich industrial heritage.

Elektrostal has a long history of industrial development, contributing to the growth and progress of the region.

Founded in 1916.

The city of Elektrostal was founded in 1916 as a result of the construction of the Elektrostal Metallurgical Plant.

Located approximately 50 kilometers east of Moscow.

Elektrostal is situated in close proximity to the Russian capital, making it easily accessible for both residents and visitors.

Known for its vibrant cultural scene.

Elektrostal is home to several cultural institutions, including museums, theaters, and art galleries that showcase the city’s rich artistic heritage.

A popular destination for nature lovers.

Surrounded by picturesque landscapes and forests, Elektrostal offers ample opportunities for outdoor activities such as hiking, camping, and birdwatching.

Hosts the annual Elektrostal City Day celebrations.

Every year, Elektrostal organizes festive events and activities to celebrate its founding, bringing together residents and visitors in a spirit of unity and joy.

Has a population of approximately 160,000 people.

Elektrostal is home to a diverse and vibrant community of around 160,000 residents, contributing to its dynamic atmosphere.

Boasts excellent education facilities.

The city is known for its well-established educational institutions, providing quality education to students of all ages.

A center for scientific research and innovation.

Elektrostal serves as an important hub for scientific research, particularly in the fields of metallurgy, materials science, and engineering.

Surrounded by picturesque lakes.

The city is blessed with numerous beautiful lakes, offering scenic views and recreational opportunities for locals and visitors alike.

Well-connected transportation system.

Elektrostal benefits from an efficient transportation network, including highways, railways, and public transportation options, ensuring convenient travel within and beyond the city.

Famous for its traditional Russian cuisine.

Food enthusiasts can indulge in authentic Russian dishes at numerous restaurants and cafes scattered throughout Elektrostal.

Home to notable architectural landmarks.

Elektrostal boasts impressive architecture, including the Church of the Transfiguration of the Lord and the Elektrostal Palace of Culture.

Offers a wide range of recreational facilities.

Residents and visitors can enjoy various recreational activities, such as sports complexes, swimming pools, and fitness centers, enhancing the overall quality of life.

Provides a high standard of healthcare.

Elektrostal is equipped with modern medical facilities, ensuring residents have access to quality healthcare services.

Home to the Elektrostal History Museum.

The Elektrostal History Museum showcases the city’s fascinating past through exhibitions and displays.

A hub for sports enthusiasts.

Elektrostal is passionate about sports, with numerous stadiums, arenas, and sports clubs offering opportunities for athletes and spectators.

Celebrates diverse cultural festivals.

Throughout the year, Elektrostal hosts a variety of cultural festivals, celebrating different ethnicities, traditions, and art forms.

Electric power played a significant role in its early development.

Elektrostal owes its name and initial growth to the establishment of electric power stations and the utilization of electricity in the industrial sector.

Boasts a thriving economy.

The city’s strong industrial base, coupled with its strategic location near Moscow, has contributed to Elektrostal’s prosperous economic status.

Houses the Elektrostal Drama Theater.

The Elektrostal Drama Theater is a cultural centerpiece, attracting theater enthusiasts from far and wide.

Popular destination for winter sports.

Elektrostal’s proximity to ski resorts and winter sport facilities makes it a favorite destination for skiing, snowboarding, and other winter activities.

Promotes environmental sustainability.

Elektrostal prioritizes environmental protection and sustainability, implementing initiatives to reduce pollution and preserve natural resources.

Home to renowned educational institutions.

Elektrostal is known for its prestigious schools and universities, offering a wide range of academic programs to students.

Committed to cultural preservation.

The city values its cultural heritage and takes active steps to preserve and promote traditional customs, crafts, and arts.

Hosts an annual International Film Festival.

The Elektrostal International Film Festival attracts filmmakers and cinema enthusiasts from around the world, showcasing a diverse range of films.

Encourages entrepreneurship and innovation.

Elektrostal supports aspiring entrepreneurs and fosters a culture of innovation, providing opportunities for startups and business development.

Offers a range of housing options.

Elektrostal provides diverse housing options, including apartments, houses, and residential complexes, catering to different lifestyles and budgets.

Home to notable sports teams.

Elektrostal is proud of its sports legacy, with several successful sports teams competing at regional and national levels.

Boasts a vibrant nightlife scene.

Residents and visitors can enjoy a lively nightlife in Elektrostal, with numerous bars, clubs, and entertainment venues.

Promotes cultural exchange and international relations.

Elektrostal actively engages in international partnerships, cultural exchanges, and diplomatic collaborations to foster global connections.

Surrounded by beautiful nature reserves.

Nearby nature reserves, such as the Barybino Forest and Luchinskoye Lake, offer opportunities for nature enthusiasts to explore and appreciate the region’s biodiversity.

Commemorates historical events.

The city pays tribute to significant historical events through memorials, monuments, and exhibitions, ensuring the preservation of collective memory.

Promotes sports and youth development.

Elektrostal invests in sports infrastructure and programs to encourage youth participation, health, and physical fitness.

Hosts annual cultural and artistic festivals.

Throughout the year, Elektrostal celebrates its cultural diversity through festivals dedicated to music, dance, art, and theater.

Provides a picturesque landscape for photography enthusiasts.

The city’s scenic beauty, architectural landmarks, and natural surroundings make it a paradise for photographers.

Connects to Moscow via a direct train line.

The convenient train connection between Elektrostal and Moscow makes commuting between the two cities effortless.

A city with a bright future.

Elektrostal continues to grow and develop, aiming to become a model city in terms of infrastructure, sustainability, and quality of life for its residents.

In conclusion, Elektrostal is a fascinating city with a rich history and a vibrant present. From its origins as a center of steel production to its modern-day status as a hub for education and industry, Elektrostal has plenty to offer both residents and visitors. With its beautiful parks, cultural attractions, and proximity to Moscow, there is no shortage of things to see and do in this dynamic city. Whether you’re interested in exploring its historical landmarks, enjoying outdoor activities, or immersing yourself in the local culture, Elektrostal has something for everyone. So, next time you find yourself in the Moscow region, don’t miss the opportunity to discover the hidden gems of Elektrostal.

Q: What is the population of Elektrostal?

A: As of the latest data, the population of Elektrostal is approximately XXXX.

Q: How far is Elektrostal from Moscow?

A: Elektrostal is located approximately XX kilometers away from Moscow.

Q: Are there any famous landmarks in Elektrostal?

A: Yes, Elektrostal is home to several notable landmarks, including XXXX and XXXX.

Q: What industries are prominent in Elektrostal?

A: Elektrostal is known for its steel production industry and is also a center for engineering and manufacturing.

Q: Are there any universities or educational institutions in Elektrostal?

A: Yes, Elektrostal is home to XXXX University and several other educational institutions.

Q: What are some popular outdoor activities in Elektrostal?

A: Elektrostal offers several outdoor activities, such as hiking, cycling, and picnicking in its beautiful parks.

Q: Is Elektrostal well-connected in terms of transportation?

A: Yes, Elektrostal has good transportation links, including trains and buses, making it easily accessible from nearby cities.

Q: Are there any annual events or festivals in Elektrostal?

A: Yes, Elektrostal hosts various events and festivals throughout the year, including XXXX and XXXX.

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Planet Fitness Hold Rating: Balancing Softer Comps Outlook with Strategic Growth Initiatives

Analyst Max Rakhlenko of TD Cowen maintained a Hold rating on Planet Fitness ( PLNT – Research Report ), with a price target of $66.00.

Max Rakhlenko has given his Hold rating due to a combination of factors surrounding the performance and strategic moves of Planet Fitness. One primary concern affecting the rating is the softer-than-anticipated same-store sales (comps) outlook for the fiscal year 2024, which indicates a growth of only 5-6%, falling short of the expectations. This forecast takes into account the reversion of mature stores to pre-pandemic performance levels and a slower ramp-up of new stores. Rakhlenko notes that the current trends are weaker, especially at the start of the year, and that improvement is contingent on more favorable comparisons in the future. Furthermore, the health of the franchise after several consecutive years of a sluggish start is also in question. Additionally, Rakhlenko considers the company’s new growth model and the reduced marketing costs as intelligent long-term strategies, which are somewhat balanced by the better-than-anticipated guidance on new store placements. Despite a year-over-year decrease in openings, the stability in grace periods for franchisees suggests a lower risk of unforeseen challenges to new openings. Meanwhile, the pricing pilot, which is yielding mixed results, is also a factor in the Hold rating. While there is some positive movement towards premium memberships, the overall impact of new pricing strategies on membership growth and average unit volumes (AUVs) will be monitored closely in the upcoming quarter. Rakhlenko maintains a balanced view, acknowledging the company’s willingness to experiment with pricing structures to optimize member growth and revenue.

Rakhlenko covers the Consumer Cyclical sector, focusing on stocks such as O’Reilly Auto, Planet Fitness, and Home Depot. According to TipRanks , Rakhlenko has an average return of 1.1% and a 56.00% success rate on recommended stocks.

See today’s best-performing stocks on TipRanks >>

TipRanks tracks over 100,000 company insiders, identifying the select few who excel in timing their transactions. By upgrading to TipRanks Premium, you will gain access to this exclusive data and discover crucial insights to guide your investment decisions. Begin your TipRanks Premium journey today.

Planet Fitness (PLNT) Company Description:

Planet Fitness, Inc. engages in the operation and franchise of fitness centers. It operates through the following segments: Franchise, Corporate-Owned Stores, and Equipment. The Franchise segment includes operations related to the company’s franchising business in the U.S., Puerto Rico, Canada, the Dominican Republic, and Panama. The Corporate-Owned Stores segment deals with the operations with respect to all corporate-owned stores throughout the U.S. and Canada. The Equipment segment sells equipment to franchisee-owned stores. The company was founded by Michael Grondahl and Marc Grondahl in 1992 and is headquartered in Newington, NH.

Read More on PLNT:

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List of Fitness centers in Moscow Oblast

Number of fitness centers in moscow oblast with email address, phone number, geocoded address, and other key details for download., number of fitness centers, smartscrapers has the most up to date and comprehensive fitness centers list in moscow oblast. our lists are constantly being verified and our database is constantly being updated..

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Number of Fitness centers locations by each city/area

How many fitness centers are there in moscow oblast .

There are a total of 377 Fitness centers in Moscow Oblast as of January 09, 2024 .

Download the list of 377 Fitness centers in Moscow Oblast as of January 09, 2024 based on phone number, email, and both.

Number of Fitness centers in Moscow Oblast with Phone Number

Number of Fitness centers in Moscow Oblast with Email

Number of Fitness centers in Moscow Oblast with Phone Number and Email

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Perceptions of groupness during fitness classes positively predict recalled perceptions of exertion, enjoyment, and affective valence: An intensive longitudinal investigation

Scott graupensperger.

Pennsylvania State University Department of Kinesiology, ude.usp@04gas

Jinger S. Gottschall

Pennsylvania State University Department of Kinesiology, ude.usp@regnij

Alex J. Benson

University of Western Ontario Department of Psychology , ac.owu@3nosneba

Wilfrid Laurier University Departments of Kinesiology/Physical Education and Psychology, ac.ulw@syem

Bryce Hastings

Auckland University of Technology Health and Environmental Sciences

M. Blair Evans

Pennsylvania State University Department of Kinesiology, ude.usp@31ebm (Senior Author)

Associated Data

Group contexts such as fitness classes are popular forms of physical activity, and studying them can uncover new ways to promote exercise adherence. Focusing on the potential for group fitness experiences to vary from class-to-class, we examined how exercisers’ dynamic perceptions of groupness relate to recalled perceptions of exercise enjoyment, affective valence, and exertion. These outcome variables are in focus because they are theoretically construed to be determinants of physical activity. Using an intensive sampling methodology across a two-week period, 97 adult exercisers ( M age = 42.35 years) completed surveys following each fitness class attended (695 unique responses). Using multilevel confirmatory factor analysis, we confirmed a theorized two-factor structure of groupness at both the within-and between-person levels. Multilevel modeling revealed that class-to-class fluctuations in exercisers’ perceptions of groupness explained a considerable portion of variance in recalled perceptions of exertion, enjoyment, and affective valence. Specifically, during classes in which exercisers’ perceptions of groupness were relatively higher, exercisers reported more recalled enjoyment, affective valence, and exertion. Focusing on how variability in groupness perceptions may influence exercise adherence, these findings demonstrate the value in fitness classes feeling like authentic groups.

In studying the dynamic aspects of group evaluations, the current study makes novel advancements to group theories applied to exercise settings. Perhaps most notably, individuals’ variations in their cognitive evaluations of fitness groups were closely linked to their affective responses to exercise.

To combat the myriad health concerns associated with physical inactivity (e.g., cardiovascular disease), researchers have dedicated great effort to understanding individual-level factors such as cognitions, attitudes, and motivations. Both researchers and practitioners have struggled to leverage social and environmental factors that promote sustained engagement in physical activity ( Stevens et al., 2017 ). Nevertheless, groups are readily used to influence individuals’ behavior and promote physical activity across a wide array of people—ranging from youth to older adults—often in the form of sport teams and group-based physical activity interventions ( Beauchamp et al., 2018 ; Estabrooks, 2008 ; Eys & Evans, 2018 ).

In line with seminal work on the fundamental need to belong ( Baumeister & Leary, 1995 ), it is often presumed that physical activity groups can become the source of affiliation, belonging, and identity that subsequently promotes greater investment in physical activity. Indeed, strongly identifying with an exercise group predicts greater participation in physical activity and increased exercise-specific satisfaction ( Stevens, Rees, & Polman, 2018 ). However, a meta-analysis that contrasted various intervention formats for exercise found that these benefits were greater in settings that entailed strategies to foster members’ interactions and were described as ‘true groups’, compared to traditional classes (i.e., mere collectives of individuals exercising together) or home-based interventions ( Burke, Carron, Eys, Ntoumanis, & Estabrooks, 2006 ). This finding demonstrates the value of exercising in a social setting that resembles an authentic group. Extending this reasoning, although exercise and physical activity often takes place with others, the subjective meaning individuals form about whether the collective is truly a group carries a great deal of influence ( Martin, Bruner, Eys, & Spink, 2014 ).

Group settings can feel more like an authentic group when they entail: (a) a collective identity, (b) a shared sense of purpose, (c) group structure, and (d) interdependence among members ( Kozlowski & Ilgen, 2006 ). Such feelings reflect a construct termed groupness, which is the extent to which members of a collective perceive that they belong to a group and rely on fellow members, as well as the degree that members interact to form a social structure ([Blinded for peer review]; McGrath, 1984 ; Spink, Wilson, & Priebe, 2010 ).

In initial work on perceptions of groupness in exercise settings, researchers operationalized this construct as an aggregation of five group characteristics: Common fate, social structure, mutual benefit, group processes, and self-categorization ( Spink et al., 2010 ). Responding to a 5-item instrument that maps onto these characteristics of groups, those who perceived their fitness setting as entailing greater levels of groupness also reported greater frequency of physical activity in the preceding months. Although this early work sparked interest in the role of groupness within physical activity settings (e.g., Martin, Balderson, Hawkins, Wilson, & Bruner, 2017 ), it also had several shortcomings. Notably, the study involved a small sample ( N = 86), participants were asked to recall an exercise class from up to six months prior, and groupness was not assessed in relation to actual groups.

To continue advancing this literature, [blinded for peer review] recently established a theoretical and measurement-based foundation for studying groupness within exercise groups featuring two dimensions: Entitativity and group structure. First, entitativity encompasses the beliefs that individuals form about whether or not their setting is a group, as an existing entity with shared similarities and boundedness ( Campbell, 1958 ). In contrast, perceptions of group structure entail the extent that members describe their groups interacting and sharing social structures to guide those interactions - represented by member communication, roles, and shared norms ( Spink & Carron, 1993 ). In this perspective, groupness is represented through abstract cognitions (does this seem like a group ?), alongside more concrete beliefs about how others behave in ways that constitute a group (do we act like a group?).

With the advent of this revised conceptualization of groupness, it is critical to situate this construct alongside existing research on group cohesion. Specifically, group cohesion entails perceiving an exercise group as united when pursuing goals (i.e., group integration) and satisfying the affective needs that individuals hold related to the group (i.e., attraction to the group) both during the task and through social interactions ( Estabrooks & Carron, 2000 ). Whereas groupness represents one’s perceptions of how closely a collective represents a ‘true group’, cohesion is an emergent group state that takes place further downstream in that cohesion reflects one’s perceptions about the group with the assumption that the collective is indeed a ‘true group.’ More simply, groupness is a belief about whether members represent a group, regardless of affective feelings toward the group or how well members work together. With regard to theoretical temporality between the two constructs, groupness is considered to be a key antecedent of cohesion such that efforts to strengthen group cohesion often involve promoting entitativity and group structure ( Spink & Carron, 1993 ). As such, interventions commonly leverage components of groupness to build and develop cohesion through means such as setting group goals, forming norms for how members act, and assigning roles for members ( Carron, Spink, & Prapavessis, 1997 ). Although it is anticipated that groupness and cohesion share variability, the two constructs are conceptually distinct with clear justification for distinguishing groupness as a malleable property of groups.

Group dynamics researchers have critically asserted that, despite its name, the dynamic nature of groups is rarely studied ( Cronin, Weingart, & Todorova, 2011 ). Indeed, there have been several calls for group researchers to begin investigating how changes in perceptions of groups relate to behavioral outcomes. The dynamic nature of exercise groups has been demonstrated by Dunlop, Falk, and Beauchamp (2013) , who found that social cohesion within groups increased progressively across eight class sessions. A related promising approach for exploring the dynamic nature of group perceptions is to intensively sample participants and distinguish between-person associations from within-person associations using a multilevel framework. For example, researchers using this methodology found that exercisers reported more satisfaction—relative to their average level of satisfaction—following group fitness classes in which they felt greater group cohesion ( Maher, Gottschall, & Conroy, 2015 ).

The dynamic nature of exercise groups is particularly evident within group fitness classes. Classes are a popular form of group exercise—spanning clinical and recreational settings—where individuals congregate to engage in various forms of physical activity and are often led by an instructor. Existing studies of group fitness classes have been primarily constrained to cross-sectional comparisons and thus provide limited knowledge pertaining only to between-person effects (e.g., Stevens et al., 2018 ). The value in directly modelling within-person variability in associations between fitness experiences and motivational constructs is evident in the aforementioned examples (i.e., Dunlop et al., 2013 ; Maher et al., 2015 ). Emerging research is revealing novel ways of modelling these associations over time (e.g., multilevel growth curve modelling; Ntoumanis et al., 2018 ) and in integrating longitudinal evaluations of fitness instructor interventions (e.g., Ntoumanis, Thogersen-Ntoumani, Quested, & Hancox, 2017 ). As such, individual perceptions of the social aspects of fitness classes, such as groupness, may be dynamic in that they vary within-person from one class to the next (i.e., ‘class-to-class’).

Given the value in modeling the dynamic nature of group fitness, there is a clear rationale for additional longitudinal examinations of exercisers’ experiences in group fitness classes. Whereas previous research has focused on the dynamic nature of cohesion within intact groups that have consistent membership and instructors ( Maher et al., 2015 ), it is unclear how these perceptions relate to other evaluations of groups and to contexts where individuals attend classes that do not have set group rosters (e.g., drop-in style). Even within drop-in style group classes, perceptions of groupness may be a malleable aspect that could be targeted either in the absence of a true group structure (i.e., establishing entitativity among members who lack critical components of a group, like a consistent set of attendees) or could be a focus when trying to strengthen group structure. Understanding the extent to which people fluctuate in their perceptions of fitness class experiences, and the potential consequences of such fluctuations, may provide valuable insight into how fitness classes can be ideally structured to promote positive experiences and adherence.

Links between groupness perceptions and recalled exercise experiences.

Evaluating the salience of groupness perceptions in fitness classes entails (a) outlining a theoretical foundation for understanding how group evaluations relate to broader evaluations of exercise experiences and (b) identifying critical social cognitions that may position these evaluations as relevant for exercise motivation. First, existing literature indicates that exercising in groups can play a key role in individuals’ exercise experiences that are, in turn, likely to impact behavior over time ( Beauchamp et al., 2018 ; Estabrooks, 2008 ; Gilbert, Chaubet, Karelis, & Dancause, 2017 ; Maher et al., 2015 ). Although numerous frameworks explain social influences, we focus on the social identity approach to explain how higher perceptions of groupness in fitness classes may influence the quality of an exercise experience. The social identity approach is built on the proposition that psychology and behavior are shaped by the groups that individuals internalize as part of their sense of self ( Turner, Oakes, Haslam, & McGarty, 1994 ). Integrating the group into one’s self- concept produces a shift in attitudes about the social environment (e.g., increased enjoyment; motivation to engage in the group and its activities) and fosters commitment to prototypical group behaviors ( Turner, 1982 ). Social identity theorists argue that true exercise groups promote more enjoyable and pleasurable physical activity experiences because they satisfy global psychological needs (e.g., belonging and meaning; Greenaway, Cruwys, Haslam, & Jetten, 2016 ; Stevens et al., 2017 ). In both sport and exercise settings, having a shared sense of “us” has been found to predict greater attendance and adherence ( Stevens et al., 2018 ). Thus, studies that have tested tenets of a social identity approach provide a basis for the current investigation of group fitness: We generally anticipate that perceiving a higher degree of groupness will correspond to a more enjoyable and pleasurable experience.

Potential associations between evaluations of pleasure (i.e., affective valence) and enjoyment are important in light of theoretical advances in exercise psychology. Exercise-related affect and enjoyment perceptions are situated within numerous theoretical frameworks, including their centrality to intrinsic motivation (i.e., self-determination theory; Ryan & Deci, 2000 ) and as the affective component of attitudes (i.e., theory of planned behavior; Ajzen, 1991 ). Theorists particularly emphasize the predictive value of in-task affect using hedonic theoretical perspectives, whereby affective responses during activity condition responses and are predictive of physical activity behavior over time ( Ekkekakis & Lind, 2006 ; Williams, Dunsiger, Jennings, & Marcus, 2012 ). Whereas in-task affective responses are powerful predictors of behavior and the most valid representation of experiences, recent findings also demonstrate how recalled affective evaluations shape exercise cognitions such as intentions and affective forecasts ( Ruby, Dunn, Perrino, Gillis, & Viel, 2011 ). Similarly, theorists working in the domain of behavioral economics have emphasized that remembered utility (i.e., a retrospective evaluation of an experience) is predictive of whether that behavior will be repeated (e.g., Ariely & Carmon, 2000 ). Applied to the domain of remembered affective responses to exercise, Zenko, Ekkekakis, and Ariely (2016) directed researchers to consider how numerous biases that influence individuals’ recollections of past exercise could be used to produce more positive affective forecasts in exercise, claiming that: “From the standpoint of intervention, the question, then, is how the affective memories of and the affective forecasts for exercise can be improved” (p. 150). Specifically, Zenko and colleagues (2016) demonstrated that shifts in the structure of exercise sessions (e.g., hardest part first) produced more favorable recalled evaluations. Considering these research patterns, we expect that classes featuring high groupness will shape experienced affect and, importantly, recollections of previous sessions. Given the extant theoretical support, postexercise recall of exercise enjoyment and affective valence are key constructs to study in terms of proximal targets (i.e., mechanisms) that may increase exercise adherence.

Groupness perceptions may also facilitate deeper engagement in fitness classes, which we expect to be reflected in perceived exertion. Although capturing psychophysical ratings of perceived exertion in the moment is ideal (i.e., RPE; Borg, 1998 ), postexercise cognitive recall of perceived exertion is a valid indicator of exertion (e.g., Singh, Foster, Tod, & McGuigan, 2007 ). Retrospective reports of perceived exertion capture cognitions regarding the completed exercise bout (i.e., often referred to as session-RPE), but are distinct from true psychophysical indices of perceived exertion that are captured during exercise ( Foster et al., 2001 ).

Group perceptions are likely to be dynamic, and modeling this within-person variance through repeated assessments would provide a deeper understanding of how group appraisals relate to other constructs. This is particularly true of drop-in style group fitness classes, whereby the social environment can vary dramatically from one class to the next (e.g., different people in attendance). Using an intensive sampling methodology (i.e., repeated assessments following several group fitness classes), the current study investigated how class-to-class variability in perceived groupness relates to reports of recalled exertion, enjoyment, and affective valence immediately following a group fitness class. This knowledge holds theoretical implications pertaining to how groups impact how exercisers recall exercise experiences, and also holds practical implications for structuring physical activity in ways that people will enjoy and to which they will ultimately adhere. Given the intensive sampling design, a secondary goal of this research was to evaluate the factor validity of a recent measure of perceived groupness (i.e., unique entitativity and group structure subscales; [blinded for peer review]).

First, we anticipated a two-factor structure of groupness at both the within- and between-person levels. Pertaining to the primary focus of this study, with the expectation that rich group experiences are more pleasurable, we hypothesized that perceptions of groupness would be positively related to exercisers’ reports of recalled affective valence and enjoyment. Furthermore, with evidence that individuals may exert more effort when they exercise in a true group (e.g., Martin, Anderson, Schmale, Hallworth, & Hazell, 2016 ), we expect that groupness perceptions may carry social motives to report exerting more effort (assessed through postclass recall of exertion). Although entitativity and group structure are conceptually distinct dimensions of groupness, no specific hypotheses were made for differential associations with study constructs. Finally, although the novelty of the research question precluded us from making explicit multilevel hypotheses, the dynamic nature of group environments is expected to be captured by the intensive longitudinal design. As such, we generally anticipated that variance in the outcome variables would be more strongly predicted by groupness at the within-person level than at the between-person level.

Participants and Procedures

All study procedures were approved by the first author’s institutional ethics review board. Participants were adult members of a small group fitness facility in the Northeastern United States. Although a total of 181 members completed at least one survey, the multilevel approach required participants to provide responses to three or more time points during the two-week study period for inclusion in the main analyses. The final sample of 97 members ( M age = 42.35; SD = 12.49) completed an average of 7.16 class surveys (SD = 3.30), totaling 695 unique responses. Sample size in multilevel analyses is more heavily dependent on the number of between-person respondents (number of individuals) than the number of within-person responses (number of responses per person). Methodologists have found evidence that when studies entail at least 50 between-person respondents (i.e., 50 participants), multilevel analyses yield accurate estimates and unbiased standard errors ( Maas & Hox, 2005 ). As such, the current between- person sample size of 97 provides an adequate sample size for estimating multilevel effects.

The sample consisted of 85.56% women, was predominantly Caucasian, and had a mean BMI of 25.27 (SD = 4.97) based on self-report. Data were collected by members of the research team who were stationed at the fitness facility during all hours of operation for a two-week period. Immediately following each class, as participants left the exercise studio and entered the facility lobby, participants completed a brief paper-and-pencil questionnaire pertaining to characteristics of the class and feelings toward the session that they had just completed. Although this provided a brief span of time for members to cool down and put away equipment, surveys were completed before members changed or left the facility (i.e., within 10 minutes of completing the class). Demographic information was only asked of participants when they completed their first questionnaire. The average class size was 15.65 members (SD = 3.88) and class offerings included cardiovascular activities such as cycling and mixed martial arts, synchronized strength training using weights, and high-intensity interval classes. Most classes promoted vigorous intensity activity (i.e., ~80–90% max heart rate). To reduce the impact of intensive sampling (e.g., burden), we simplified the questionnaire by using single-item instruments when possible ( Ohly, Sonnentag, Niessen, & Zapf, 2010 ).

To assess perceptions of groupness during fitness classes, we used a recently developed measure that is conceptually grounded in Kozlowski and Ilgen’s (2006) definition of a true group (for full description of scale development see [ blinded for peer review ]). Item development for this measure drew upon measures of groupness ( Spink et al., 2010 ), interdependence ( Van der Vegt, Emans, & Van de Vliert, 1998 ), and entitativity ( Hogg, Sherman, Dierselhuis, Maitner, & Moffitt, 2007 ). The 6-item instrument is hypothesized to consist of two 3-item subscales. The first, entitativity, captures the degree to which participants perceive members as being an entity (e.g., “This exercise session felt like a team effort”). The second subscale, group structure, involves perceptions of members adopting roles and group norms (e.g., “Members of this class took-on roles that impacted other members”). Responses were on a 7-point Likert-type scale (1 = Not at all, 7 = Very much so). The full measure, including all six items, is available in the online supplemental materials .

Outcome variables.

To assess participants’ subjective level of recalled exertion from each exercise classes that they had just completed, we used a modified version of Borg’s (1998) Ratings of Perceived Exertion (RPE) Scale. This retrospective exertion item asked “What was the overall amount of exertion you felt in this class, today?” where response options ranged from 6 (no exertion) to 20 (maximal exertion). Whereas the RPE is designed to assess psychophysical perceptions of exertion during exercise, we used this scale to capture exercisers’ cognitive recall of their overall level of exertion during the class. Although this is a critical distinction, cognitive recall of exercise exertion is moderately correlated with physiological indices of exertion (e.g., heart rate) and is a valid indicator of perceived training intensity ( Foster et al., 2001 ). Recalled enjoyment was assessed using a single-item that has been used previously in this domain (e.g., Maher et al., 2015 ): “This class was enjoyable,” whereby participants responded on a 7-point scale (1 = Not at all, 7 = Very much so). Lastly, recalled affective valence was assessed using a modified version of the single-item Feeling Scale ( Hardy & Rejeski, 1989 ), which asked “How did you feel throughout the class you just participated in” from −5 (very bad) to +5 (very good), with several additional anchors in-between (i.e., fairly bad, neutral, and fairly good). Although this single-item measure is commonly used within exercise psychology research ( Ekkekakis, Hall, & Petruzzello, 2008 ), only the affective dimension of valence was measured (not arousal).

In an initial step to test the hypothesized two-factor structure of groupness (i.e., entitativity and group structure), we followed Hox, Moerbeek, and van de Schoot’s (2017) multilevel confirmatory factor analysis (MCFA) procedures using the ‘lavaan’ package in R ( Huang, 2017 ; Rosseel, 2012 ). We then calculated multilevel alpha for each factor ( Huang, 2017 ). These procedures are described in the supplementary material .

We used linear multilevel modeling to examine how class-to-class variability in recalled exertion, enjoyment, and affective valence link to within-person variance in perceived groupness. This enabled us to disentangle variance at the within-person level from the variance that is due to stable between-person differences. All models were fit using the ‘nlme’ package in R ( Pinheiro et al., 2017 ). We first calculated the amount of within-person variance for each outcome variable by specifying unconditional null models ( Raudenbush & Bryk, 2002 ). In the next step, we specified separate random intercept models for each outcome variable. Five theoretically relevant covariates were specified: Sex (time-invariant; coded: 1 = male, 2 = female), age at baseline (time-invariant), class size (time variant), whether the class entailed synchronous movements (time variant; coded: 1 = yes, 0 = no), and participants’ nth response (time-variant) to control for temporal ordering of participant responses.

The two groupness subscales, entitativity and group structure, were entered as fixed effects partitioned into within- and between-person components. Although the primary focus of the current study was on the within-person variance in groupness from class-to-class, it was necessary to account for the between-person variance in each model ( Enders & Tofighi, 2007 ). Between-person groupness variables were calculated as each participant’s mean score across all classes attended, while within-person groupness variables were person-mean centered ( Enders & Tofighi, 2007 ). Variance inflation factor was computed for each variable as an index of multicollinearity, whereby scores greater than 5 indicate a concern for multicollinearity ( Kutner, Nachtscheim, Neter, & Li, 2004 ). A final note relates to considering the covariance structure. When data comprise repeated measures over time, it is important to assess associations between errors (e.g., measurements closer in time may be more strongly related) and heteroscedasticity of error variances (i.e., magnitude of error variances may change across time; Bliese & Ployhart, 2002 ). Likelihood ratio testing indicated that, compared to an unstructured error variance, an autoregressive covariance structure (i.e., errors are correlated across time) demonstrated improved model fit and was therefore specified for each of the linear multilevel models.

The results of the MCFA procedures supported the two-factor model of groupness. At the within-person level, the one-factor model fit (i.e., χ 2 = 47.91, df = 9, p <.001; CFI =.961; RMSEA =.085; SRMR =.038; AIC = 8349.24) was inferior to the two-factor model fit (i.e., χ 2 = 9.26, df = 8, p =.321; CFI =.999; RMSEA =.016; SRMR =.016; AIC = 8312.59). Similarly, at the between-person level, the one-factor model (i.e., χ 2 = 68.37, df = 17 ,p <.001; CFI =.969; RMSEA =.093; SRMR =.019; AIC = 10758.94) did not fit the data as well as the two-factor model (i.e., χ 2 = 33.74, df = 16, p =.006; CFI =.989; RMSEA =.057; SRMR =.018; AIC = 10726.31). Although the MCFA supported the two-factor model of groupness, the interfactor correlations between the two subdimensions were high: r = 0.82 at the within-person level, and r = 0.90 at the between-person level. Although the MCFA supported the two-factor model of groupness, the interfactor correlations between the two dimensions were high at both the within- person ( r = 0.82) and between-person levels ( r = 0.90). Interfactor correlations are a complex and contentious issue for which no cutoffs have been established, but high values may indicate collinearity between subdimensions (i.e., lack of discriminant validity). To mitigate concerns regarding collinearity, variance inflation factor scores were computed (reported below). Multilevel alpha indices for entitativity were .96 (between) and .87 (within). Alphas for group structure were .87 (between) and .68 (within).

Additional preliminary analyses examined potential violations of assumptions. Several variables were skewed, violating the assumption of normality: Entitativity = −1.37; enjoyment = −1.79; recalled affective valence = −2.90. Box-Cox transformations were implemented to normalize the distributions of these variables, which resulted in more acceptable skewness: Entitativity = −0.75; enjoyment = −1.29; recalled affective valence = −1.14.

Table 1 displays the descriptive statistics, multilevel correlations, and intraclass correlation coefficients (ICC). Correlations were decomposed into the pooled correlation within persons and the weighted correlation of the means between persons ( Pedhazur, 1997 ). Note that correlation coefficients in longitudinal multilevel studies should be interpreted descriptively rather than inferentially, given that important information is factored-out of relations in each case (see Conroy et al. 2015 ). The ICC values were derived from the unconditional null models and are listed on the diagonal. Supporting our multilevel approach, there was significant within- person and between-person variability in the groupness subscales, although a larger portion was due to between-person differences. Further, there was a considerable portion of within-person variability in recalled exertion, enjoyment, and affective valence.

Descriptive statistics, bivariate correlations, and intraclass correlation coefficients.

Note. Intraclass correlation coefficients (i.e., proportion of between-person variance) are displayed on the diagonal. Between-person level correlation coefficients are shown below the diagonal and within-person correlation coefficients are shown above the diagonal. M = sample-level mean, SD = sample-level standard deviation. Entitativity, Group Structure, and Enjoyment scales ranged from 1 (not at all) to 7 (very much so). Recalled exertion scale ranged from 6 (no exertion at all) to 20 (maximum exertion). Affective valence ranged from −5 (very bad) to +5 (very good).

Results from the linear multilevel models are displayed in Table 2 . Within-person variance (i.e., time-varying) in entitativity (γ40 = 0.15 ;p <.001) and group structure (γ50 = 0.07; p =.002) were positively associated with perceived exertion. In other words, participants recalled exerting themselves more during classes in which they perceived greater groupness. Within- person variance in entitativity (γ40 = 0.20; p <.001) and group structure (γ50 = 0.10; p =.021) were positively associated with enjoyment. That is, participants recalled more enjoyment from classes in which they perceived relatively more groupness. Lastly, participants recalled experiencing higher (i.e., more positive) affective valence during classes in which they perceived greater levels of entitativity (γ40 = 0.20 ;p < .001). At the between-person (i.e., time-invariant) level, entitativity was positively associated with recalled enjoyment (γ03 = 0.24 ;p < .001) and affective valence (γ03 = 0.27; p < .001), meaning that exercisers who generally held higher overall perceptions of entitativity—averaged across all classes attended—reported greater recalled enjoyment and recalled increasingly positive affective valence during fitness classes. Variance inflation factor scores indicated only a minimal amount of multicollinearity among the study variables ( Table 2 ).

Linear multilevel models predicting recalled exertion, enjoyment, and affect ive valence in group exercise classes.

Note. All fixed effects are unstandardized regression coefficients. Error variances are heterogeneous (i.e., allowed to vary across classes). BW = Between-person level; WI = Within-person level. VIF = Variance inflation factor. Synch = Class entailed synchronous movement.

We investigated how variability in perceptions of groupness in fitness classes across time relate to exercisers’ ratings of recalled exertion, enjoyment, and affective valence. Whereas studies have investigated dynamic social aspects of group fitness classes (e.g., cohesion; Maher et al., 2015 ), this is the first study to our knowledge that has modeled exercisers’ dynamic perceptions of groupness within the exercise environment across time. Using an intensive sampling methodology, we documented how fluctuations in perceived groupness are systematically related to important psychological and behavioral variables, though our models were primarily predictive at the within-person level. Broadly speaking, fitness classes are perceived more positively and relate to greater recalled exertion when they are perceived to be higher in groupness.

Postexercise recollections of exercise enjoyment and affective valence are core evaluations of fitness experiences that shape the social-cognitive evaluations of exercise (e.g., anticipated affect and intentions), which are key determinants of exercise adherence and maintaining a physically active lifestyle ( Ruby et al., 2011 ; Zenko et al., 2016 ). Although studies have linked group cohesion to exercise satisfaction ( Maher et al., 2015 ), the current findings demonstrate how class-to-class changes in perceived entitativity are positively associated with exercisers’ reports of enjoyment with the fitness class, as well as perceptions of recalled affective valence during exercise. Given that group structure was not significantly related to recalled affective valence, the results indicate that entitativity may be a more salient feature for these aspects than the presence of group communication, roles, and norms within a fitness class. Drawing attention toward the recalled nature of affective valence, it is plausible that either these effects could demonstrate: (a) that groupness shapes the immediate exercise experience, or (b) that individuals more readily access the positive affective and enjoyment elements when exercising in classes featuring high groupness. Although it is essential to disentangle these two processes, these relations between groupness and recalled affective valence and enjoyment produce compelling findings regarding how high perceptions of groupness could impact exercise cognitions.

It is generally expected that individuals will make more positive evaluations about a collective of individuals when it feels more like a true group (i.e., “we”; Stevens et al., 2018 ). Considering that recalled enjoyment and affective valence perceptions were formed within the context of groups, links to groupness align with social identity theory. We anticipate that a collective of exercisers that feels more like a true group has greater potential to become internalized into a person’s sense of self identity, which may imbue the exercise session with deeper meaning for the individual ( Haslam, Cruwys, Haslam, Dingle, & Chang, 2016 ). Greenaway and colleagues (2016) have surmised that identifying with a group facilitates constructive helping between members (e.g., support) that enables individuals to overcome challenges and stressors. Given that intense physical activity entails predominately negatively valanced affective evaluations, exercising with a group that one identifies more closely with may enhance exercisers’ postclass affective recollections of the experience. However, joining an intact ‘true’ exercise group is not always a feasible option. For example, joining an authentic exercise group requires that members always meet at a rigid time that may not work well with other life demands (e.g., children). As such, drop-in style group fitness classes that resemble an authentic group may foster a group identity that shapes immediate evaluations and (potentially) more distal behaviors alongside one’s sense of self.

Considering alternative explanations for the link between groupness and recalled exertion, exertion may also represent a ‘sacrifice’ that generates stronger groupness perceptions ( Swann, Gómez, Huici, Morales, & Hixon, 2010 ). That is, a collective of exercisers exerting themselves may feel a sense of incongruity if the setting they are doing so within is not a true group and, as such, people are motivated to justify their effort by increasing their perceptions of groupness. As theoretical support for this argument, researchers have indicated that sharing painful experiences—even with complete strangers—can enhance interpersonal relationships with those people ( Bastian, Jetten, & Ferris, 2014 ). Considering that this compelling alternative is as-of-yet untested, a future direction is to conduct experimental research that manipulates physical exertion (i.e., randomly assign individuals to high or low intensity) alongside the structure of group environments (i.e., randomly assign to high or low group interaction). By measuring perceived exertion and groupness in these varying environments, researchers may better understand the temporality of the association between groupness and exertion.

Additional theoretical implications for this research emerge through findings that exercisers reported greater recalled exertion concurrent with more positive recollections of affective valence when groupness perceptions were higher. These findings raise questions about why groupness and recalled exertion are associated, and how groupness may influence the exertion-affect association. Although we anticipated that exercising in a group provides social motives for putting forth or perceiving greater effort, intense feelings of exertion are generally an unpleasant feeling for many individuals ( Ekkekakis, Parfitt, & Petruzzello, 2011 ). Thus, the finding that participants reported feeling that the exercise class was harder when groupness was high is somewhat contradictory to the finding herein that participants recalled feeling greater enjoyment and more affective valence when groupness was high.

Of course, past evidence for associations among the concepts of exertion and affective valence mean that it is also important to consider these results synergistically. Because groupness was positively associated with both affective valence and exertion, it is prudent to consider whether groupness may moderate or confound the exertion-affect association. Even though high-intensity training results in physiological gains related to long-term health, many individuals experience negative affective valence during high-intensity exercise - leading to concerns about the risks of promoting high-intensity training to the general population (e.g., Ekkekakis et al., 2011 ). The idea that social forces may play a role in this association is supported in recent research: Compared to individual workouts, participants in ‘true groups’ felt more intrinsically motivated to engage in high-intensity exercises ( Martin et al., 2016 ). Although these findings provide preliminary support for exploring these associations, an understanding of the role of groupness demands a more diverse population and a wider spectrum of exercise intensities.

Practical Implications

In addition to advancing group dynamics theory applied to exercise, the current study holds several practical implications. A primary takeaway from the current findings is that perceptions of groupness are related to more positive postexercise cognitive evaluations. As a result, group exercisers’ experiences may be enhanced by facilitating perceptions that class members are not only exercising alongside one another, but are indeed exercising together. This suggestion is consistent with a growing body of research on ways of enhancing social evaluations of group-based physical activity. For example, among older adults, physical activity groups are perceived more positively when the members are more similar in age ( Bennett et al., 2018 ). Researchers have also found that exercisers perceive greater entitativity and group structure in classes that involve more opportunity for member interactions, in larger classes, in classes that do not require equipment, and in classes that entail synchronous movement among members ([blinded for peer review]). Nonetheless, as the current study entailed a correlational approach, additional work is required to provide stakeholders with a clear set of guidelines for promoting groupness.

Beyond the context of drop-in style group fitness classes, the implications of this research could extend to other domains of group-based exercise. A real-world illustration of group exercise that is also grounded in the social identity approach is parkrun; a weekly community event where individuals of all ages and abilities meet in a park to complete a five kilometer run (see Stevens et al., 2018 ). Leaders of parkrun highlight clear group norms prior to each run (e.g., support fellow runners, even if you must sacrifice a personal best), and encourage a sense of togetherness alongside continual reminders that it is not a race. Applying the current findings to parkrun, as an example, stakeholders may be able to prompt greater levels of enjoyment, positive affective valence, and exertion (or enhanced postexercise recollections of these constructs) by creating a group setting that provides clear sentiments of entitativity and group structure.

Limitations

In addition to its strengths, there are limitations to the current study in terms of sampling as well as decisions related to measurement and methodology. To maximize ecological validity, the current sample was limited to participants who self-selected into a membership at a group fitness facility and consisted primarily of women. This could create range-restriction issues and hamper our ability to detect associations between constructs of interest. The nature of the current sample also limits the potential to generalize these results to inactive or diverse populations who may gain the most from group-based exercise ( Harden et al., 2015 ). Although sampling exercisers from ‘drop-in’ style group fitness classes advances the literature in this domain, most participants attended many classes over the course of the 2-week study period, which may lead to closer connections with fellow exercisers than one would typically expect through a drop-in setting. Nevertheless, we argue that the ecological validity is strong given that the group fitness facility that participants were drawn from is representative of this type of exercise setting.

Regarding methodological limitations, the results of the MCFA on groupness supported the theorized two-factor model. Nevertheless, the high interfactor correlations between these two factors indicates that exercisers’ perceptions of group structure and entitativity carry potential overlap. Whereas we computed indices within analyses as evidence that collinearity was not a concern, additional research studying the measurement of groupness is critical to provide further support for its discriminant validity - particularly among the two subscales. We also note that the findings may be confounded by common method bias given that all data were self-reported, several of the items used similar scaling, and all items for each class survey were completed at the same time. Although this limitation is prevalent across the sport and exercise psychology literature, we encourage researchers to overcome this weakness in future studies by assessing variables on a variety of scales (e.g., visual analog scale; Zenko et al., 2016 ), or through means other than self-report, such as video coding. Pertaining to the single-item measure used to assess exercisers’ enjoyment, the response scale used for enjoyment (i.e., ‘not at all’ to ‘very much so’) does not capture that bipolar nature of enjoyment. That is, a bipolar scaling where options range from ‘I enjoyed it’ to ‘I hated it’ are more appropriate ( Kendzierski & DeCarlo, 1991 ).

The timing of assessments should also be considered as to distinguish the postexercise reports captured within the current research from the theoretical value of assessments taken during exercise tasks. Considering that participants’ responses of all study variables were recorded within ten minutes following fitness classes, responses may have been confounded by recall biases whereby the exercise itself may have been unpleasant, but having completed the workout feels great afterwards. As described earlier in this discussion, the group environment may also lead to more positive recollections than the aggregate of perceptions during the activity itself. Expectations that recalled perceptions are likely to vary in contrast to participants’ actual experiences are indeed supported by the observation of relatively positive evaluations represented in the high means for enjoyment, exertion, and affective valence. Although data were collected as immediately following exercise as possible, it is prudent that future work develop methods for assessing these constructs during exercise in a naturalistic setting without hampering exercisers’ experiences - while also integrating additional approaches to ensure truthful responding.

Whereas decisions to record postexercise evaluations were logical on one hand (e.g., logistical hurdles to capturing these variables during exercise in a community fitness center), these decisions are also bound to theory given the unique value of recalled affect. Notably, research grounded in behavioral economics has demonstrated that when exercise experiences are registered in memory as more enjoyable, they lead to more positive anticipated affect for future bouts of exercise, which is predictive of exercise intentions and adherence ( Conner, McEachan, Taylor, O’Hara, & Lawton, 2015 ; Zenko et al., 2016 ). Thus, despite limitations of postexercise sampling, recollections of exercise experiences nevertheless hold conceptual and practical value for understanding exercise behavior.

Alongside benefits to studying group exercise classes in a naturalistic community setting, the variability in class type (e.g., cycling) may introduce confounds. This limitation may be most relevant to exercisers’ reports on recalled exertion, whereby the level of exertion may be reflective of the class setting rather than an exerciser’s engagement of effort. Future work may consider assessing participants’ perceived effort rather than exertion. Lastly, we were unable to track participants’ exercise behaviors beyond the two-week study period, meaning that we were limited to studying proximal outcomes that may be associated with exercise adherence, but unable to track actual adherence. Future research should explore this avenue to understand the direct association between groupness and exercise adherence, and to also test whether the perceptions of recalled affective valence and enjoyment mediate this association.

One method of increasing physical activity in adults, that has theoretical and empirical support, is participation in group fitness classes (Eys & Evans, 2018). Our findings advance this literature by showing how fluctuations in exercisers’ perceptions of groupness explained a considerable portion of the variance in recalled exertion, enjoyment, and affective valence, which are theorized to be key determinants of physical activity. Specifically, when groupness was higher during fitness classes, greater exertion was reported and exercisers held higher perceptions of enjoyment and affective valence. Ultimately, as it pertains to fitness classes, groupness is a positive perception that may be proximally targeted in attempt to promote exercise adherence.

Supplementary Material

Acknowledgments.

FUNDING: The project described was supported by the NIH National Center for Advancing Translational Sciences (TL1 TR002016) and National Institute for Drug Abuse (T32 DA017629). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Furthermore, this work was partially supported by a small research contract with Les Mills International.

Contributor Information

Scott Graupensperger, Pennsylvania State University Department of Kinesiology, ude.usp@04gas .

Jinger S. Gottschall, Pennsylvania State University Department of Kinesiology, ude.usp@regnij .

Alex J. Benson, University of Western Ontario Department of Psychology , ac.owu@3nosneba .

Mark Eys, Wilfrid Laurier University Departments of Kinesiology/Physical Education and Psychology, ac.ulw@syem .

Bryce Hastings, Auckland University of Technology Health and Environmental Sciences.

M. Blair Evans, Pennsylvania State University Department of Kinesiology, ude.usp@31ebm (Senior Author)

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    The annual ACSM's Health & Fitness Journal ® worldwide survey to determine industry trends by health and fitness professionals is now in its 17th consecutive year. The COVID-19 pandemic certainly made an impact on the 2021 survey and continued for 2022, but for 2023, some current trends are emerging whereas others are weakening because of the world's recovery from the isolation caused by ...

  18. The Gym as a Culture of Body Achievement: Exploring Negative and

    Research article First published online May 23, 2018 The Gym as a Culture of Body Achievement: Exploring Negative and Positive Body Image Experiences in Men Attending University Larkin Lamarche, Kimberley L. Gammage, and Brianne Ozimok View all authors and affiliations All Articles https://doi.org/10.1177/2158244018778103 PDF / ePub More Abstract

  19. Towards a geography of fitness: an ethnographic case study of the gym

    Given these contexts, a detailed case study is presented to demonstrate the potential for geographical research on fitness. Through an observational study of a specialist gym facility, the study investigates how bodybuilding culture and place are co-produced. Indeed, the gym provides a narrative resource and a crucial setting for individual ...

  20. The Effect of Men's Body Attitudes and Motivation for Gym Attendance

    Introduction. A body of research has focused on how men's attitudes toward their body influence exercise-related behavior (3,6,39,40,45).Men who experience dissatisfaction with their body are likely to spend more time exercising and to attend a gym more regularly (); however, the motivational orientations of such gym goers (i.e., the nature of the rationales behind engaging in exercise at the ...

  21. 'Movement is medicine': Changing the fitness mindset

    Dubbed Cozy Cardio, this concept of creating a comfortable and pleasing space to exercise in private on your own time is not a new one, according to Dr. Timothy Michael, professor of exercise science, but it's now gaining traction across social media platforms for championing low-impact, easy-movement fitness.. One of the Cozy Cardio pioneers is TikTok's Hope Zuckerbrow, who has ...

  22. Anthropology 101: A Cultural Anthropologist Walks into a Gym

    Written by Katie Rose Hejtmanek, PhD Last updated on August 3rd, 2023 Editors note: Katie Hejtmanek, Ph.D. is a cultural anthropologist conducting research on the culture of strength sports in...

  23. High levels of niacin linked to heart disease, new research suggests

    High levels of niacin, an essential B vitamin, may raise the risk of heart disease by triggering inflammation and damaging blood vessels, according to new research.

  24. Status of the research in fitness apps: A bibliometric analysis

    Highlights • A bibliometric analysis of the fitness apps research field to gain insight into the state of the art. • Scopus and Web of Science were used to collect the data (481 records). • Statistical analysis and science mapping were used to analyze the data. •

  25. Is Red Wine Actually Good for You? How the Drink Affects Heart Health

    Within months, an industry-funded group had organized a symposium to debate the research, and they invited Dr. Fillmore. In notes Dr. Stockwell saved, Dr. Fillmore wrote that the discussion was ...

  26. 40 Facts About Elektrostal

    A center for scientific research and innovation. Elektrostal serves as an important hub for scientific research, particularly in the fields of metallurgy, materials science, and engineering. ... such as sports complexes, swimming pools, and fitness centers, enhancing the overall quality of life. Provides a high standard of healthcare ...

  27. Planet Fitness Hold Rating: Balancing Softer Comps Outlook with

    Analyst Max Rakhlenko of TD Cowen maintained a Hold rating on Planet Fitness (PLNT - Research Report), with a price target of $66.00. Max Rakhlenko has given his Hold rating due to a combination ...

  28. Number Of Fitness centers in Moscow Oblast

    List of Fitness centers in Moscow Oblast with email address, phone number, geocoded address, and other key details for download. Data updated on September 25, 2023. $79. $790 (90% off) PURCHASE DATASET FREE SAMPLE DATASET. PROFSTYLE. 4.7 61 reviews. Sovkhoznaya Ulitsa, 7. Khimki, Moscow Oblast; Russia;

  29. Perceptions of groupness during fitness classes positively predict

    Go to: Abstract Group contexts such as fitness classes are popular forms of physical activity, and studying them can uncover new ways to promote exercise adherence.