Research Article: Associations of Health Club Membership with Physical Activity and Cardiovascular Health

Date Published: January 20, 2017

Publisher: Public Library of Science

Author(s): Elizabeth C. Schroeder, Gregory J. Welk, Warren D. Franke, Duck-chul Lee, Conrad P. Earnest.


This study evaluates whether a health club membership is associated with meeting the US physical activity (PA) guidelines and/or favorable cardiovascular health.

Using cross-sectional data of health club members (n = 204) and non-members (n = 201) from April to August 2013, this is the first study to our knowledge to examine a health club membership in relation to objectively measured cardiovascular health indicators including resting blood pressure, resting heart rate, body mass index, waist circumference, and cardiorespiratory fitness based on a non-exercise test algorithm. To determine the total PA and sedentary time, this study used a comprehensive PA questionnaire about both aerobic and resistance activities at the health club, as well as lifestyle activities in other settings, which was developed based on the International Physical Activity Questionnaire (IPAQ).

The odds ratios (95% confidence interval) of meeting either the aerobic, resistance, or both aerobic and resistance PA guidelines for members compared to non-members were 16.5 (9.8–27.6), 10.1 (6.2–16.3), and 13.8 (8.5–22.4), respectively. Significant associations of health club membership with more favorable cardiovascular health outcomes and sedentary behavior were observed for resting heart rate (B: -4.8 b/min, p<0.001), cardiorespiratory fitness (B: 2.1 ml/kg/min, p<0.001), and sedentary time (B: -1.4 hours, p<0.001). Participants with a health club membership of >1 year had more favorable health outcomes, with a smaller waist circumference (men, B: -4.0 cm, p = 0.04; women, B: -3.4 cm, p = 0.06), compared to non-members.

Health club membership is associated with significantly increased aerobic and resistance physical activity levels and more favorable cardiovascular health outcomes compared to non-members. However, longitudinal, randomized controlled trials would be clearly warranted as cross-sectional data prohibits causal inferences.

Partial Text

The United States Department of Health and Human Services has established specific goals to increase the number of individuals who meet the current physical activity (PA) guidelines [1]. Current evidence-based physical activity guidelines (PAG) recommend at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic activity per week, or an equivalent combination of both [2]. The PAG also recommend participation in muscle-strengthening activities on 2 or more days per week for additional health benefits not found with aerobic activity [2]. However, most studies have focused on aerobic activity and more data are needed regarding the distribution and determinants of muscle-strengthening activities such as resistance exercise [3].

There were 204 participants with a health club membership and 201 participants without a health club membership. Those with a health club membership were significantly more active and less sedentary (Table 1). Regarding total PA, including both health club and lifestyle activities, 87% and 84% of members compared to 30% and 36% of non-members met the aerobic PAG and resistance PAG, respectively. The prevalence of meeting both aerobic and resistance PAG was 75% in members and 18% in non-members in additional analysis. Those with a health club membership were also more fit and had a lower resting heart rate (Table 2).

The primary finding of this study is the significant associations of health club membership with increased aerobic and resistance PA levels as well as favorable cardiovascular health outcomes including resting heart rate, cardiorespiratory fitness, and obesity measures. Additionally, an increased length of membership was more strongly associated with increased physical activity and favorable cardiovascular health outcomes.

In conclusion, this study suggests that health club membership was associated with increased PA and more favorable CVD health markers, especially with longer duration of membership. With the declining average monthly fee for health club membership [29] and the increasing support from employers and insurance companies, this study supports that promoting PA at a health club could be an effective public health strategy for health promotion and potentially health care cost reduction. However, large longitudinal, randomized controlled trials are clearly warranted to confirm our findings.