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Research Bites

Yoke, Mary M. Ph.D., M.A., M.M., FACSM

ACSM's Health & Fitness Journal: May/June 2018 - Volume 22 - Issue 3 - p 29–30
doi: 10.1249/FIT.0000000000000381
Columns: Research Bites

Mary M. Yoke, Ph.D., M.A., M.M., FACSM,has recently earned her doctorate in health behavior at the Indiana University School of Public Health, where she was previously a full-time faculty member in the Department of Kinesiology. Before her position in Indiana, she was an adjunct professor at Adelphi University for 22 years, where she authored or coauthored numerous group exercise research studies. She is the author of four texts on fitness; she has presented in 11 countries and throughout the United States on a wide variety of health/fitness topics and has obtained 23 certifications. Her research interests include behavior change, positive psychology, motivation, and group fitness and personal training efficacy.

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In an article published by the American Psychological Association (1), researchers Deighton-Smith and Bell reported that certain online social media sites encouraged unrealistic body images and fitness messages. After performing a content analysis of 944 of the most recent posts of #fitspiration images on Instagram, the authors identified six main themes used on the site: fit is sexy (and sexiness is a major reason to exercise), commitment and self-regulation are required for a fit physique (no excuses), your choices define you (poor choices = laziness and weakness), you must persevere through pain (without regard for any negative outcomes), you will encounter a battle within yourself, and celebration of the #fitspiration community (including a sense of superiority over those who don’t participate and contempt for those who don’t measure up to an ideal body type).

The authors note that, for the general public, the media is prominent in shaping fitness ideals and providing information, even though several studies have shown that this information often is incorrect or misleading. In one study, 59% of adults looked for health information online in the previous year (2). The overall trend in media is the promotion of attractiveness, or sexiness, instead of health, well-being, and increased functional abilities. Fitness is therefore idealized in the service of external and extrinsic goals, with physical attractiveness being the main goal. Furthermore, fit bodies (and especially women’s bodies) often are objectified and dehumanized. This is more likely when the female body is presented scantily clothed, wearing form-fitting and revealing clothing. It has been shown that both male and female observers objectify or self-objectify the female body when shown these types of images (3). Sexual objectification of women’s bodies has been shown to contribute to hostile sexism and negative social comparisons. Objectification theory suggests that women who objectify themselves experience shame, low self-esteem, body dissatisfaction, eating disorders, anxiety, and depression and are less likely to pay attention to internal bodily cues and needs.

It’s worth noting that, in addition to being hypersexualized, women also are portrayed with excessive thinness and smallness in many #fitspiration posts. Findings from Deighton-Smith and Bell included the following: women were significantly more likely than men to be photographed faceless, with only body parts or full-body shots being shown; women were more likely than men to wear sexualized clothing and to reveal their legs and buttocks; men, in contrast, were more likely than women to be shown in upper body shots without visible clothing, displaying upper body musculature. For men, negative social media influence may result in unhealthy muscle-building practices and fasting. The authors conclude that popular #fitspiration posts promote sexual objectification and encourage pervasive and negative sociocultural appearance ideals. It is recommended that social media focus on positive health outcomes and the increased ability to respond to physical demands as a result of becoming fit, rather than the acquisition of a sexy body or stereotypical assumptions of female and male attractiveness.

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In a 2017 study published in the International Journal of Sports Physical Therapy (4), researchers explored whether exercises performed using the modality of suspension training (e.g., on a TRX) increased muscle activation more than when the same exercises were performed on a standard, stable surface such as the floor. Suspension training, where either the hands or feet are suspended from free-hanging straps that are anchored to a wall, ceiling, or other stable device (such as the top of a Smith press machine), greatly increases the instability of an exercise. Performing a suspended and unstable exercise is purported to require more core and stabilizer muscle involvement.

To address the hypothesis of increased muscle involvement with suspension training, 25 adults (average age, 27.24 years) were asked to perform four randomized exercises using the TRX system, as well as four similar randomized exercises on the floor. Body positioning and joint angles were matched as much as possible between the two modalities. An electromyographic machine was used to measure muscular contraction levels for each exercise and for each participant. The exercises on the TRX were push-up (upper body suspended), inverted row (upper body suspended), supine bridge (lower body suspended), and forearm plank (lower body suspended). A standard push-up, supine bridge, and forearm plank also were performed with both hands and feet on the floor, and the inverted row was performed with feet on the floor and hands on a stable bar.

The findings? Statistical analyses showed that there was significantly greater muscle activation in specific muscles during each of the suspension training exercises versus when the exercises were performed on the floor. Specifically, obliques were recruited more strongly in the TRX plank; pectoralis major, rectus abdominis, obliques, rhomboids, and erector spinae were recruited more strongly in the TRX push-up; rectus abdominis and erector spinae were more strongly activated in the TRX bridge; and rectus abdominis was more strongly activated in the TRX inverted row. Suspension training seems to be a valuable alternate modality to stable surface training because several muscles show increased activation in common exercises when compared with the same exercises performed on the floor.

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Intuitively, it should come as no surprise that the more a person can tolerate high-intensity exercise discomfort, the harder they are likely to work during a given exercise session. The concept of exercise tolerance is gaining traction in the scientific literature, especially with regard to the fact that a majority of citizens (~91%) do not meet Physical Activity Guidelines for Americans (5). Perhaps a main reason for the epidemic of physical inactivity is low exercise tolerance.

Researchers Flack, et al. (6) examined the relationship between meeting physical activity guidelines and the ability to tolerate, and even prefer, higher measures of exercise intensity. Exercise tolerance and the reinforcement of exercise (the amount of work a person is willing to do to perform an exercise behavior) were assessed for both aerobic activity and muscle strengthening activity in 87 study participants (mean age: 24.9; mean body mass index: 25.7). The main research question was whether adults who meet physical activity guidelines have greater tolerance to discomfort and higher exercise intensity in aerobic and/or resistance modalities than those who do not meet the guidelines.

Results? Of the 87 participants, 13.8% met the physical activity recommendation of 75 minutes of vigorous activity per week; these 12 participants also had 58% higher tolerance/reinforcement of exercise measures. It was found that 23 participants (26.4%) met the guidelines for muscle strengthening exercise, and these had a 54% greater reinforcement (i.e., willingness to work hard) than those who did not meet the recommendations (a significant difference). The authors also found that resistance training intensity tolerance/reinforcement was higher in men than women, and that resistance training measures were not highly correlated with aerobic training measures. Interpretation of these results should be applied cautiously, particularly because all study participants were young and healthy, and a majority of clients seeking a health/fitness professional’s advice are middle aged or older.

Take-home message: the amount of physical work a person is willing to do, and the degree of discomfort he or she is willing to endure, are factors in meeting current activity recommendations. A greater tolerance for higher exercise intensity may be necessary to meet guidelines, and this is problematic for those who can’t, or won’t, tolerate discomfort or perceived lengthy periods of physical work. It also should be noted that high exercise intensities are correlated with decreased exercise adherence. Another way of saying this is that the more discomfort many people experience, the less pleasurable the activity, and the less likely they are to continue. These findings present a conundrum for health/fitness professionals. We know that adherence to physical activity guidelines results in numerous health and fitness benefits, yet the guidelines clearly present challenges for a majority of Americans. How can we help the inactive public increase their exercise tolerance and reinforce beliefs around exercise, and thus maintain lifelong physical activity according to established guidelines? This is a question that needs further research.

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1. Deighton-Smith N, Bell BT. Objectifying fitness: a content and thematic analysis of #fitspiration images on social media. Psychol Pop Media Cult. 2017. [Epub ahead of print]
2. Fox S, Duggan M. Health Online 2013. [Internet]. Pew Research Center. [cited 2018 February 23]. Available from:
3. Bernard P, Gervais SJ, Allen J, Campomizzi S, Klein O. Integrating sexual objectification with object versus person recognition: the sexualized-body-inversion hypothesis. Psychol Sci. 2012;23(5):469–71.
4. Harris S, Ruffin E, Brewer W, Ortiz A. Muscle activation patterns during suspension training exercises. Int J Sports Phys Ther. 2017;12(1):42–52.
5. Tucker JM, Welk GJ, Beyler NK. Physical activity in U.S.: adults compliance with the Physical Activity Guidelines for Americans. Am J Prev Med. 2011;40(4):454–61.
6. Flack KD, Johnson L, Roemmich JN. Aerobic and resistance exercise reinforcement and discomfort tolerance predict meeting activity guidelines. Physiol Behav. 2017;170:32–6.
© 2018 American College of Sports Medicine.