Physical Activity and Public Health

TLDR: Further explanation is required of Dr Pate and colleagues' Figures 1 and 2 and the recommendation's contradiction with research that supports more vigorous activity, as well as their Figure 1, which shows a diminishing return in health benefit with increasing exercise level.

Abstract: To the Editor. —The Special Communication by Dr Pate and colleagues 1 provides an important message to sedentary adults. However, I believe that further explanation is required of their Figures 1 and 2 and the recommendation's contradiction with research that supports more vigorous activity. Their Figure 1 shows a diminishing return in health benefit with increasing exercise level. Measurement of the illustrated curvilinear plot shows a 12-fold greater health benefit from increasing physical activity status in sedentary individuals compared with physically active individuals. "Active" presumably means expending the caloric equivalent of walking 2 miles briskly most days of the week. It can mean no more than that for the horizontal x-axis to be linear, which is essential for the graph to have meaning. I am unaware of any data to support this substantial disparity in benefit. My own study of runners suggests that cardiovascular risk factors are improved as the