Women exercise less than men but see greater benefits, study says

Women generally exercise less than men, but new research suggests they reap greater health benefits.

A national study found that women who exercised regularly (at least 2.5 hours at moderate intensity or 75 minutes vigorously per week) had a 24% lower risk of dying during the study period compared to women who did not. They exercised.

In contrast, men who exercised regularly were 15% less likely to die than men who did not exercise.

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Men also needed more exercise than women to achieve the same health benefits: Five hours of moderate or vigorous exercise per week reduced their risk of dying by 18% compared to men who didn’t exercise. But just 140 minutes of weekly exercise had the same effect among women.

“Women had the same benefit with lower levels of physical activity,” said study co-author Dr. Martha Gulati, director of preventive cardiology at the Smidt Heart Institute at Cedars-Sinai in Los Angeles.

Women who exercised regularly also had a 36% lower risk of dying from a cardiovascular problem such as a heart attack or stroke, the study found, while men who exercised regularly had a 14% lower risk.

The findings were published Monday in the Journal of the American College of Cardiology. Researchers analyzed the self-reported exercise habits of more than 412,000 men and women who participated in the National Health Interview Survey between 1997 and 2017.

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About a third of the women regularly performed aerobic exercises (those that raise the heart rate, such as brisk walking, jumping rope or taking spinning classes) compared to 43% of the men in the study. Women were also less likely than men to do muscle-strengthening activities, such as lifting weights.

However, regular muscle strengthening (about one session per week, on average) was associated with a 30% lower risk of women dying from cardiovascular problems and a 19% lower risk of dying overall. Among men, the same weekly exercise reduced the risk of dying from cardiovascular problems by 11% and of death by the same percentage.

Gulati said a major limitation of the study is that it did not take into account how active the women were outside of training environments.

“Missing in our data are the things we do every day: the other physical activity that is not going to the gym but running after the kids, gardening, doing housework,” he said.

Should men and women have different exercise recommendations?

The Department of Health and Human Services recommends that adults perform 150 minutes of moderate physical activity per weekincluding two days of muscle-strengthening activities.

But Gulati said those guidelines “can be very overwhelming for someone who does nothing.” Many of her patients have difficulty finding time to exercise, she said.

“Women are busy. Women work. Women tend to take on most of the family responsibilities, whether they are children or elderly parents, and when the day is over, there is very little time left,” Gulati said.

Data from the National Health Interview Survey suggests that women in 2022 were more likely than men to have been advised in the past year by doctors or other health professionals to increase their amount of physical activity.

“Instead of talking about 150 minutes a week, the way we should say it is: What can you do?” Gulati said.

Paul Arciero, a professor of sports, medicine and nutrition at the University of Pittsburgh, said it makes sense to have different exercise guidelines for men and women.

“There are clear sex-based differences in response to exercise,” he said. “We have to go beyond thinking that men and women respond in similar ways.”

What is causing the difference based on sex?

Many studies have shown that exercise does not affect men and women in the same way.

Arciero’s 2022 research found that women had greater reductions in blood pressure when they exercised in the morning, while men had greater reductions in the evening. A 2020 review also found that women’s muscles are more resistant to fatigue caused by high-intensity exercise.

But scientists have been less sure about how those differences affect people’s long-term health.

The new study shows that “women are basically more efficient at responding to exercise, particularly when it comes to heart health and mortality,” said Arciero, who was not involved in the paper.

Arciero said physiological differences may contribute to this advantage: Women have more capillaries — small blood vessels — in a given section of muscle than men, which could allow more blood and oxygen to flow to the heart during exercise.

Women also have higher levels of the hormone estrogen, which improves blood flow, said Lynda Ransdell, chair of the kinesiology department at Boise State University.

Ransdell also pointed out a third factor: Women tend to be less physically active, so it may take less effort to improve their health compared to their starting points.

“I would call it the principle of diminishing returns,” Ransdell said. “Since women typically start out at lower levels of fitness, they can see significant improvements if they do a little less physical activity.”

But scientists have more to learn, he added.

“While I love this study and think it is innovative and iconic, I also think it is one piece of a puzzle,” Ransdell said. “I would love to see them do more research with objective measures of physical activity like pedometers or Apple watches.”