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Cited by 843Physical Activity and HealthCardiovascular and exercise physiologyExercise and Physiological Responses

Dose–response issues concerning physical activity and health: an evidence-based symposium

ANTERO KESANIEMI (Chair), Y., DANFORTH, ELLIOT, JENSEN, MICHAEL D., KOPELMAN, PETER G., LEF??BVRE, PIERRE, REEDER, BRUCE A.·2001·Medicine and Science in Sports and Exercise
DOI 10.1097/00005768-200106001-00003
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Abstract

Regular physical activity is widely accepted as a behavior to reduce all-cause mortality rates and to improve a number of health outcomes. On October 11–15, 2000, Health Canada and the United States Centers for Disease Control and Prevention sponsored a scientific symposium to determine whether there is a dose-response relationship between physical activity and several health-related outcomes and to identify areas for future research. The invited experts reviewed and evaluated the existing literature according to an evidence-based methodology used previously by the National Institutes of Health (5) (Table 1). The Consensus Committee (Panel), consisting of individuals with experience and knowledge in health areas of concern from outside the field of exercise science, reviewed and evaluated the evidence presented, assigned it to an evidence category, and identified topics for future research. The manuscripts upon which the consensus was based and the report of the Consensus Committee are published concurrently in this issue of Medicine & Science in Sports & Exercise. Table 1: Categories of evidence.aMost of the evidence currently available seems to be related to the effects (benefits or risks) of regular physical activity rather than to the relationship between dose and response. Therefore, the Panel decided to summarize the evidence for the effects of participation in regular physical activity, because the Panel found this useful and necessary to properly understand the dose-response data. The key terms used during the Symposium and in this report are described in detail by Howley (4). Briefly, health is defined as a human condition with physical, social, and psychological dimensions. Physical activity is defined as any bodily movement produced by contraction of skeletal muscle that substantially increases energy expenditure. The dose of physical activity, or exercise, needed to bring about a particular health benefit response is described by the characteristics of frequency, duration, intensity, and type of activity. Frequency is described as the number of activity sessions per time period (e.g., day or week). Duration refers to the number of minutes of activity in each session. Intensity describes, in relative or absolute terms, the measured or estimated effort (energy cost) associated with the physical activity. Physical activity may be of a leisure time or occupational type activity. Physical fitness is defined as a set of attributes (i.e., cardiorespiratory endurance, skeletal muscle endurance, skeletal muscle strength, etc.) that relate to the ability to perform physical activity. The product of frequency, duration, and intensity yields the total energy expenditure associated with the physical activity and is a measure of the volume of exercise. The gross cost of an activity is the total energy expenditure, which includes resting metabolic rate and the cost of the activity itself. The net cost is that associated with the activity alone. BACKGROUND Concepts and Methods Appropriate measurements of physical activity are needed to judge whether there is a dose-response relationship between physical activity and health. Ideally, the important components of physical activity include measurements of frequency and duration (time) and intensity (absolute and relative). With these measurements, it is possible to calculate the dose (or volume) of exercise. Unfortunately, many studies have not collected detailed measures on intensity, duration, and frequency but have used subjective assessments such as “little, moderate, and heavy.” The dose equals the energy expended in physical activity and is one of the potential mediators of the health benefits of physical activity. Therefore, relatively accurate measurements of both the time spent in physical activity and intensity of physical activity are needed. This is a problem because the methods used in field studies (questionnaires, physical activity records, and recall diaries) are imprecise, particularly for estimating low levels of physical activity. These methods rely on self-reports of the individual’s perceived intensity of physical activity. They may not reflect the absolute intensity across all age and sex groups required for converting the perceived levels of exercise intensity into METs, a commonly used unit used to estimate the metabolic cost (oxygen consumption) of physical activity. One MET equals the resting metabolic rate (∼kcal·min-1 or 3–5 mL O2·kg-1·min-1). The lack of a gold standard for the precise quantification of the energy expenditure of physical activity has hampered the development of universally acceptable and accurate field assessment techniques. A variety of direct and indirect methods are presently used to assess physical activity. Portable oxygen uptake devices and improved sensors of bodily movements and temperature continue to be investigated, but more work and better consensus regarding their uniform application are needed. Older and/o

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  • Excess body fat is poorly estimated by BMI in sedentary subjects or those with chronic diseases.

    “This finding suggests that excess body fat is poorly estimated by BMI in sedentary subjects or those with chronic diseases.”

    From Overweight and obesity in a Swiss city: 10-year trends (2007) · cites this paper as [31]

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Authors
ANTERO KESANIEMI (Chair), Y., DANFORTH, E., JENSEN, M. D., KOPELMAN, P. G., LEF??BVRE, P., & REEDER, B. A.
Affiliations
University of Vermont (US)
ORCID
REEDER, BRUCE A.
Venue
Medicine and Science in Sports and Exercise
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2001-06
Volume
33
Issue
Supplement
Pages
S351-S358
ISSN
0195-9131 (ISSN-L)
DOI
10.1097/00005768-200106001-00003
OpenAlex
W1996011673
Cited by
843
References
5
Citations by year
2026: 6 · 2025: 15 · 2024: 17 · 2023: 30 · 2022: 17 · 2021: 27 · 2020: 15 · 2019: 33 · 2018: 27 · 2017: 29 · 2016: 37 · 2015: 31 · 2014: 39 · 2013: 59 · 2012: 45
FWCI
13.36
Type
journal article
Language
en
Open access
closed
Locations
  • Medicine & Science in Sports & Exercise (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
Keywords
physical activity, dose-response relationship, exercise volume, exercise intensity, exercise frequency, exercise duration, all-cause mortality, cardiovascular disease, cancer risk, diabetes risk, physical fitness, energy expenditure, exercise risk, evidence-based consensus, health benefits of physical activity, future research directions, exercise recommendations, health policy recommendations, health care costs
MeSH terms
Adult, Age Factors, Aged, Anxiety Disorders, Cardiovascular Diseases, Chronic Disease, Depression, Diabetes Mellitus, Type 2, Female, Health Status, Humans, Hyperlipidemias, Male, Middle Aged, Neoplasms, Obesity, Physical Fitness, Public Health, Quality of Life, Risk Factors, Sex Factors, Time Factors, Exercise, Evidence-Based Medicine

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