Exercise Response Efficiency: A Novel Way to Enhance Population Health?

The rates of obesity and its related comorbidities have increased substantially over the last 30 years, with approximately 35% of all US adults now classified as obese. Whilst the causes of obesity are both complex and multifactorial, one contributor is a reduction in leisure time physical activity, with no concurrent reduction in energy intake. Physical activity interventions have been demonstrated to promote fat loss, yet more than 50% of US adults undertake no leisure time physical activity at all, with a lack of time and enjoyment often cited as the main drivers of rising inactivity levels. Furthermore, recent evidence has demonstrated that a sub-group of individuals may experience no improvement in a given fitness or health-related measure following a specific training programme, suggesting that there may be optimal exercise types for different groups of individuals. In this paper, we introduce the concept of exercise response efficiency, whereby individuals are matched to the training type from which they are most likely to derive the greatest improvements for the least time commitment. We propose that a more precise targeting of exercise interventions is likely to drive more rapid improvements in health, thereby promoting exercise adherence and enjoyment, whilst simultaneously reducing obesity and mortality risks. Such an innovation would, we suggest, confer important public health benefits.