Most adults skip strength training, though under an hour a week goes a long way

Key takeaways

• Federal guidelines call for muscle-strengthening work on at least 2 days a week, but only about 1 in 4 U.S. adults meet both the strength and aerobic goals, federal survey data show¹³.
• In a 2022 review of 16 long-term studies, people who did any strength training had 10% to 17% lower risks of death and several major diseases, with the lowest risk at roughly 30 to 60 minutes a week⁶.
• In people with high blood pressure, strength training lowered systolic pressure by about 6 points on average, similar to the effect of blood pressure medicines, according to the American Heart Association⁷.
• A 2026 review of 137 research reviews found that training to failure, machines instead of free weights and complex plans didn’t consistently improve results, while 2 to 3 sets per exercise, twice a week, built strength well⁹¹¹.
• Check with a clinician before starting if effort brings on chest discomfort, dizziness or unusual breathlessness, or if you have heart, kidney or metabolic disease and aren’t active now¹⁴.

In March 2026, the American College of Sports Medicine (ACSM) issued its first major update on strength training since 2009⁹. The expert team, which included McMaster University kinesiologist Stuart Phillips, drew on 137 systematic reviews that together covered more than 30,000 people⁹.

The group’s first takeaway wasn’t about the perfect number of sets. It was this: the biggest jump in results comes from going from no strength training to any at all¹⁰.

That’s the step most Americans haven’t taken.

Strength training, also called resistance training, means making your muscles work against a force. That force can be a dumbbell, a band, a machine or your own body. This article covers what it does beyond your muscles, how little it takes, and a two-day plan you can start this week.

Two days a week is the goal, and most adults fall short

The 2018 Physical Activity Guidelines for Americans, still the current edition, call for muscle-strengthening activity of at least moderate intensity on 2 or more days a week¹. Each week’s work should cover all the major muscle groups, because strength gains stay local: training your legs does little for your arms¹.

Few people meet that goal. In 2020, just 24.2% of adults met both the strength and aerobic guidelines, the National Center for Health Statistics reports³. Healthy People 2030, the federal health-tracking program, shows little change since, with 26.4% meeting both in 2024².

By comparison, 47.2% of adults met the aerobic guideline in 2024³. Strength is the missing half.

The gaps between groups are wide:

• Education. In 2022, 12.2% of adults 25 and older with no more than a high school education met both goals, compared with 33.6% of college graduates⁴.
• Age. Among adults 65 and older, 13.9% met both in 2022. For those 85 and older, the figure was 6.2%⁵.
• Current activity. Only 3.6% of adults who get no aerobic exercise do strength training, compared with 43.5% of aerobically active adults, the American Heart Association (AHA) reports⁷.

Strength work tracks with a longer life, up to a point

In 2022, a team led by Haruki Momma pooled 16 studies that followed adults for years, publishing in the British Journal of Sports Medicine⁶. People who did any muscle-strengthening activity had a 15% lower risk of dying from any cause than people who did none⁶.

Their risk of cardiovascular disease was 17% lower, total cancer 12% lower and type 2 diabetes 17% lower, even after the researchers accounted for aerobic exercise⁶.

More wasn’t always better. The curve was J-shaped, with the lowest risk of death at about 40 minutes a week, cardiovascular disease at about 60 and cancer at about 30⁶. Beyond roughly 130 to 140 minutes a week, the curves no longer showed lower risk than doing none, and the authors called the effect of such high amounts unclear⁶.

People who did both strength and aerobic activity had about 40% lower death rates than people who did neither⁶.

Keep the limits in mind. These were observational studies, which watch people rather than assign them to exercise, and people who choose to lift may differ in healthy ways that statistics can’t fully remove⁶. Activity was self-reported, most studies came from the United States, and the authors rated the certainty of most findings as very low⁶.

Read the J-curve as a sign that you don’t need hours. It isn’t proof that more is dangerous.

The benefits reach your blood pressure, blood sugar, bones and mood

Randomized trials, which assign people by chance to train or not, can show cause and effect. The AHA’s 2023 scientific statement on resistance training, published in Circulation, summarized that evidence⁷:

• Blood pressure. The biggest effect showed up in people with high blood pressure, whose readings fell by about 6 points systolic (the top number) and 5 diastolic on average. Healthy adults over 40 saw about 4 and 2⁷. The AHA puts the systolic drop in the same range as what blood pressure drugs deliver⁷.
• Blood sugar. Young, healthy people saw no change in fasting glucose. Older adults and people with prediabetes or type 2 diabetes saw drops of roughly 2 to 5 mg/dL⁷. Among older adults with type 2 diabetes, hemoglobin A1c, a measure of average blood sugar over about three months, dropped 0.34 percentage points⁷.
• Bones. Women before and after menopause gained bone density at the hip and lower spine. The benefit was greatest when lifting was combined with high-impact activity such as jumping rope or tennis⁷. A later article in this library covers bone strength.
• Mood. A 2018 analysis in JAMA Psychiatry pooled 33 randomized trials with 1,877 people⁸. Strength training eased depressive symptoms by a moderate amount, whether people were healthy or ill, and whether or not they got much stronger⁸.

One caution on mood: trials that kept assessors unaware of who trained found smaller benefits, so the true effect is probably more modest⁸. Exercise can be part of care for depression, not a replacement for it. If you’re in distress, call or text 988.

What the 2026 review says matters, and what doesn’t

The ACSM position stand graded the evidence behind each training choice¹¹. A handful made a clear difference¹¹:

• Frequency. Work every major muscle group on two or more days each week.
• Load, if you want maximum strength. Choose weights near 80% of your one-rep max, do 2 to 3 sets, and put that exercise near the start of your workout.
• Volume, if you want bigger muscles. Aim for about 10 or more hard sets per muscle group each week. Gains leveled off around 18 to 20 sets.

Just as useful is what didn’t consistently matter¹¹:

• Going to failure. Stopping about 2 or 3 reps short of failure was enough.
• Heavy vs. light, for muscle size. Loads anywhere from 30% to 100% of your one-rep max built similar size. Heavier loads mattered mainly for maximum strength.
• Rest between sets. Short or long rests made no consistent difference to strength gains.
• Machines vs. free weights. No difference for strength. Bands, home programs and circuits also beat doing nothing.
• Complex planning. Elaborate training cycles weren’t better than simply making the work harder over time.

A 2023 analysis by the McMaster group compared 12 programs across 178 trials¹². Every program beat doing nothing, and age, sex and training experience didn’t clearly change the results¹².

Two disclosures. Brad Schoenfeld, a co-author of the 2026 position stand, formerly sat on the scientific advisory board of Tonal, a maker of home fitness equipment¹¹. In the 2023 analysis, Phillips reported grants from dairy groups and Nestlé Health Science¹². Neither review received outside funding¹¹¹².

Phillips summed up the main lesson in the ACSM’s announcement: “The best resistance training program is the one you’ll stick with”⁹.

A two-day starter plan at three levels

Pick the column that fits your equipment, and stick with the same five moves on two nonconsecutive days, such as Monday and Thursday. Each session takes about 20 to 30 minutes, which puts your week near the 30 to 60 minute range linked to the lowest risks⁶.

Movement	Level 1: Bodyweight or bands	Level 2: Dumbbells	Level 3: Gym
Squat (thighs, hips)	Stand up from a chair and sit back down	Goblet squat, holding one dumbbell at your chest	Leg press or barbell squat
Hinge (back of thighs, hips, lower back)	Glute bridge on the floor	Dumbbell Romanian deadlift	Trap-bar deadlift
Push (chest, shoulders, triceps)	Wall or countertop push-up	Dumbbell press on a bench or the floor	Chest-press machine or bench press
Pull (upper back, biceps)	Band row, band anchored in a door	One-arm dumbbell row, other hand on a bench	Seated cable row or lat pulldown
Carry (grip, trunk, posture)	Walk 30 to 40 steps with two loaded grocery bags	Walk holding a dumbbell in each hand	Same walk, with heavier dumbbells or kettlebells

How much to do:

1. Weeks 1 and 2: 1 set of 10 to 12 reps per move. Stop at an effort of about 5 or 6, with 4 or more reps still in reserve.
2. Weeks 3 to 6: 2 sets of 8 to 12 reps. Stop at about 7, with 2 or 3 reps in reserve¹¹. Rest as long as you need between sets; shorter and longer rests worked about equally for strength¹¹.
3. Week 7 on: 2 to 3 sets per move¹¹. After about six months, if maximum strength is your goal, you can add weeks with heavier weights you can lift only about 8 times⁷¹².

The progression rule. The AHA describes a “2 for 2” rule⁷. Once you beat your rep target on an exercise by 2 in two straight sessions, raise the weight by roughly 2% to 10%⁷.

Picture a beginner doing goblet squats with a 25-pound dumbbell for 2 sets of 10. When she gets 12 clean reps on both sets two sessions in a row, she moves to 27.5 pounds and drops back to 10 reps. At Level 1, “more weight” means a stronger band or a harder version of the move, which our bodyweight exercise article lays out.

Women and older adults lift the least, and both respond well

A large U.S. study published in 2024 in the Journal of the American College of Cardiology followed more than 400,000 adults for about two decades¹³. Compared with people who didn’t exercise, women who did strength training had a 19% lower risk of death, while men had an 11% lower risk¹³. For cardiovascular deaths, the figures were 30% for women and 11% for men¹³.

Yet only 20% of women did a weekly strength session, compared with 28% of men¹³. This was an observational study, so it shows a link, not proof.

Women respond in trials, too: nearly half the participants in the 2023 McMaster analysis were women, and sex didn’t clearly change the results¹².

The ACSM position stand calls strength training safe for healthy adults of all ages, though its authors suspect only about 10% to 15% of older people follow programs like the ones it describes¹¹. The AHA notes that older adults gained more from 2 to 3 sets at moderate to fairly heavy loads than from one light set, and that programs with balance challenges may do the most to prevent falls⁷.

One adjustment: the ACSM authors suggest training to failure may be unwise for some older people because of blood vessel and injury risks¹¹. For protein, see our article on protein needs.

Safety: blood pressure, breathing and the clinician check

Strength training has a better safety record than many people assume. In a review of 23 trials in people with coronary heart disease, cited by the AHA, there were 63 nonfatal heart complications during aerobic training and testing and 1 during strength training⁷. The AHA calls those data limited⁷.

The AHA says people whose high blood pressure is under control can safely do low- to moderate-intensity strength work, as long as they breathe properly⁷. A common coaching cue: exhale as you lift or push, inhale as you lower, and never hold your breath. If you take blood pressure medicine, the AHA advises a longer cool-down to keep your pressure from dropping too low afterward⁷.

Stop and get checked if you feel dizzy, have chest pain or pressure, notice a racing or pounding heartbeat, or get unusually short of breath⁷. Sharp or joint pain is also a reason to stop and adjust.

You don’t need a doctor’s visit for most starts. Under the ACSM’s screening approach, people without known heart, metabolic or kidney disease and without symptoms can begin at light to moderate effort and build up gradually¹⁴.

What the evidence shows

Claim	Evidence rating	What it rests on
Strength training builds strength and muscle at any adult age	Strong evidence	137 reviews and a 178-trial analysis; every program beat no exercise1112
It lowers blood pressure, most in people with hypertension	Strong evidence	Trial data summarized by the AHA; about 6/5 points in hypertension7
It modestly improves blood sugar in older adults and people with diabetes	Strong evidence	Trials summarized by the AHA; A1c down 0.34 points7
It eases depressive symptoms	Strong evidence (size uncertain)	33 randomized trials; smaller effects in better-blinded trials8
About 30 to 60 minutes a week is linked to a longer life	Promising but early	Observational studies with very low certainty6
More than about 2 hours a week cancels the benefit	Not enough evidence	Few data at high amounts; authors call it unclear6
You must train to failure or use machines to see results	Evidence says no	No consistent advantage in the 2026 review11

Strength is old-fashioned, and that’s the point

For most of history, daily work kept people strong: lifting, digging, hauling water, carrying children. Strength training brings that back into lives that no longer demand it.

That fits natural-health values. The 2026 review found that bands, bodyweight and home workouts all have supporting evidence¹⁰. You don’t need a gym contract, a branded machine or a supplement to start.

It also justifies healthy skepticism. When a fitness company or influencer sells a secret method, remember that complex plans and machines didn’t consistently beat simple, steady work⁹¹¹.

Questions readers ask

The bottom line

Strength training is the half of the activity guidelines most adults skip, and it asks for less than many people think. Two short sessions a week that work your legs, hips, back, chest and arms put you in the range linked to the lowest risks, and trials show real gains in blood pressure, blood sugar, bone and mood.

Keep it simple: five basic moves, 2 to 3 sets, stopping a couple of reps short, and a little more challenge whenever the work gets easy. Use what you have at home, check with a clinician first if you have symptoms or a heart, kidney or metabolic condition, and stay with it.

Related reading

• Bodyweight moves build real strength, and a wall sit may even lower blood pressure
• Who needs the new protein goal of up to twice the RDA
• Your heart counts the weekly total while your habits count the repeats
• Some healthy habits clash with your medicines, so check these goals first
• Sleep, food and easy days beat most recovery gadgets

Sources

1. Piercy KL, Troiano RP, Ballard RM, et al. “The Physical Activity Guidelines for Americans.” JAMA, 2018;320(19):2020–2028 (CDC Stacks copy). stacks.cdc.gov
2. Office of Disease Prevention and Health Promotion. “Increase the proportion of adults who do enough aerobic and muscle-strengthening activity — PA‑05.” Healthy People 2030, accessed October 2026. odphp.health.gov
3. National Center for Health Statistics. “Exercise or Physical Activity.” FastStats, CDC, updated April 14, 2026. cdc.gov
4. Haile G, Zablotsky B. “QuickStats: Percentage of Adults Aged ≥25 Years Who Met Physical Activity Guidelines for Both Aerobic and Muscle-Strengthening Activity, by Educational Attainment — National Health Interview Survey, United States, 2022.” MMWR, 2024;73(22):521. cdc.gov
5. Elgaddal N, Kramarow E. “Physical Activity Among Adults Age 65 and Older: United States, 2022.” National Health Statistics Reports No. 215, National Center for Health Statistics, 2024. ncbi.nlm.nih.gov
6. Momma H, Kawakami R, Honda T, Sawada SS. “Muscle-strengthening activities are associated with lower risk and mortality in major non-communicable diseases: a systematic review and meta-analysis of cohort studies.” British Journal of Sports Medicine, 2022;56(13):755–763. pubmed.ncbi.nlm.nih.gov
7. Paluch AE, Boyer WR, Franklin BA, et al. “Resistance Exercise Training in Individuals With and Without Cardiovascular Disease: 2023 Update: A Scientific Statement From the American Heart Association.” Circulation, 2024;149:e217–e231. doi:10.1161/CIR.0000000000001189 (copy hosted by fisiologiadelejercicio.com). fisiologiadelejercicio.com
8. Gordon BR, McDowell CP, Hallgren M, Meyer JD, Lyons M, Herring MP. “Association of Efficacy of Resistance Exercise Training With Depressive Symptoms: Meta-analysis and Meta-regression Analysis of Randomized Clinical Trials.” JAMA Psychiatry, 2018;75(6):566–576 (Iowa State University repository). dr.lib.iastate.edu
9. American College of Sports Medicine. “ACSM Unveils Landmark 2026 Resistance Training Guidelines, First Update in 17 Years.” News release via Newswise, March 17, 2026. newswise.com
10. American College of Sports Medicine. “5 Things to Know About Creating an Effective Resistance Training Plan.” Infographic, March 2026. acsm.org
11. Currier BS, D’Souza AC, Fiatarone Singh MA, et al.; Phillips SM. “American College of Sports Medicine Position Stand. Resistance Training Prescription for Muscle Function, Hypertrophy, and Physical Performance in Healthy Adults: An Overview of Reviews.” Medicine & Science in Sports & Exercise, 2026;58(4):851–872. doi:10.1249/MSS.0000000000003897 (copy hosted by fisiologiadelejercicio.com). fisiologiadelejercicio.com
12. Currier BS, Mcleod JC, Banfield L, et al. “Resistance training prescription for muscle strength and hypertrophy in healthy adults: a systematic review and Bayesian network meta-analysis.” British Journal of Sports Medicine, 2023;57:1211–1220. pubmed.ncbi.nlm.nih.gov
13. National Institutes of Health. “Women may realize health benefits of regular exercise more than men” (on Ji H, Gulati M, Huang TY, et al., Journal of the American College of Cardiology, 2024). News release, February 20, 2024. nih.gov
14. Tsakirides C, Stavropoulos-Kalinoglou A. “Physiology Group Screening Process” (adapted from ACSM’s Guidelines for Exercise Testing and Prescription, 10th edition). Leeds Beckett University, July 2020. Www.Leedsbeckett.Ac.Uk