The association of aerobic, resistance, and combined exercises with the handgrip strength of middle-aged and elderly Korean adults: a nationwide cross-sectional study

Background Handgrip strength (HGS), an indicator of overall muscle strength, is a key component in sarcopenia diagnosis. Although exercise is an effective strategy to prevent sarcopenia, the most appropriate exercise type targeting sarcopenia needs to be established. This study aimed to investigate the relationship between the physical activity (PA) patterns and HGS. Methods This was a cross-sectional study using the data from the 7th Korea National Health and Nutrition Examination Survey (2016-2018). The study population included 12,814 adults aged >= 40 years. According to the World Health Organization PA guidelines for public health, both aerobic (moderate to vigorous PA >= 150 min/week) and resistance exercises (>= 2 sessions/week) are recommended. Study participants were categorized into one of the four groups depending on their adherence to each of two exercise guidelines ("neither," "aerobic only," "resistance only," and "combined"). By defining normal HGS cutoff values as the lowest quartile of HGS from the population aged 20 years and above, we classified participants as "preserved" HGS group if their HGS was equal to or above the cutoff values. A Poisson regression model was used to calculate adjusted prevalence ratios (APRs) for preserved HGS across the four PA guideline adherences stratified by age and sex groups. Results In middle-aged adults, the "combined" exercise group was independently associated with the preserved HGS (male, age 50-59 years, APR = 1.072; male, age 60-69 years, APR = 1.180; female, age 50-59 years, APR = 1.112; female, age 60-69 years, APR = 1.188). For adults aged >= 70 years, meeting only aerobic or resistance exercise guidelines showed a positive association with HGS before adjusting for other health-related variables. In males of >= 70 years, the APR of preserved HGS was highest in the "combined" exercise group ("resistance only," APR = 1.459, "combined," APR = 1.664), while in women aged >= 70 years, the significance was lost after adjusting for covariates. Conclusions Adults meeting both aerobic and resistance exercise guidelines were associated with the highest prevalence of preserved HGS. Performing both types of exercise might be the most effective way to prevent sarcopenia that should be investigated in future clinical trials.