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Background  Many sedentary adults have high body fat along with low fitness, strength, and lean body mass (LBM) which are associated with poor health independently of body mass. Physical activity can aid in prevention, management, and treatment of numerous chronic conditions. The potential efficacy of resistance training (RT) in modifying risk factors for cardiovascular and metabolic disease is clear. However, RT is under researched in public health. We report community-based studies of RT in sedentary (Study 1), and overweight and pre-diabetic (Study 2) populations.    Methods  Study 1 - A semi randomised trial design (48-weeks): Participants choosing either a fitness centre approach, and randomised to structured-exercise (STRUC,  n  = 107), or free/unstructured gym use (FREE,  n  = 110), or not, and randomised to physical-activity-counselling (PAC,  n  = 71) or a measurement only comparator (CONT,  n  = 76). Study 2 - A randomised wait list controlled trial (12-weeks): Patients were randomly assigned to; traditional-supervised-exercise (STRUC,  n  = 30), physical-activity-counselling (PAC,  n  = 23), either combined (COMB,  n  = 39), or a wait-list comparator (CONT,  n  = 54). Outcomes for both were BF mass (kg), LBM (kg), BF percentage (%), and strength.    Results  Study 1: One-way ANCOVA revealed significant between group effects for BF% and LBM, but not for BF mass or strength. Post hoc paired comparisons revealed significantly greater change in LBM for the STRUC group compared with the CONT group. Within group changes using 95%CIs revealed significant changes only in the STRUC group for both BF% (− 4.1 to − 0.9%) and LBM (0.1 to 4.5 kg), and in FREE (8.2 to 28.5 kg) and STRUC (5.9 to 26.0 kg) for strength.  Study 2: One-way ANCOVA did not reveal significant between group effects for strength, BF%, BF mass, or LBM. For strength, 95%CIs revealed significant within group changes for the STRUC (2.4 to 14.1 kg) and COMB (3.7 to 15.0 kg) groups.    Conclusion  Strength increased in both studies across all RT treatments compared to controls, yet significant improvements in both strength and body-composition occurred only in programmed and/or supervised RT. As general increases in physical activity have limited impact upon body-composition, public health practitioners should structure interventions to include progressive RT.    Trial registration  Study 1:  ISRCTN13024854 , retrospectively registered 20/02/2018. Study 2:  ISRCTN13509468 , retrospectively registered 20/02/2018).

bmc public health

Programming and supervision of resistance training leads to positive effects on strength and body composition: results from two randomised trials of community fitness programmes