Exercise intensity can be expressed in absolute terms (e.g., oxygen uptake in liters per min, power output in watts, heart rate in beats per min, and speed of locomotion in meters per s or km per h) or in relative terms (i.e., relative to any of the following: body weight, maximal oxygen uptake, maximal heart rate, or heart rate reserve). In its simplest form, exercise intensity refers to the rate of metabolic energy demand during exercise. This information will be of value to those who prescribe exercise and in the design and interpretation of future research concerned with the associated health benefits of regular physical activity. We will then relate the common ways that moderate to vigorous exercise is described and identify which of those is most useful for accurate exercise prescription. To accomplish this, we will describe exercise intensity in the context of the metabolic responses to incremental exercise and constant intensity exercise. Here, our purpose is to provide a framework for understanding “moderate to vigorous” physical activity intensities and to recommend strategies for their individual identification for exercise prescription. (2020) makes it clear that intensity needs to be individualized relative to specific boundaries, reflecting precise metabolic conditions above which physiological homeostasis is challenged. A recent review of intensity of exercise by Jamnick et al. However, prescribing exercise at the recommended intensity requires a clear understanding of what moderate to vigorous physical activity is. The WHO and the Government of the United States of America 1 recognize the added benefit of exercising at a greater intensity to improve cardiorespiratory fitness ( Ross et al., 2015) and to reduce risk of mortality and morbidity ( Lee and Paffenbarger Jr., 2000 Wen et al., 2011). Moderate to vigorous intensity physical activity (MVPA) is commonly recommended for health benefits ( Tremblay et al., 2011), yet the majority of the population does not engage in physical activity of sufficient intensity and volume ( Warburton et al., 2007 Borgundvaag and Janssen, 2017) to obtain these health benefits. Future research should consider using these metabolic boundaries for exercise prescription, so we will gain a better understanding of the specific physical activity induced health benefits. Reassessment is necessary to maintain regular exercise in the moderate to vigorous intensity domains. As training adaptations occur, these boundaries will change in absolute and relative terms. The common practice of prescribing exercise at a fixed metabolic rate (# of METs) or percentage of maximal heart rate or of maximal oxygen uptake (V̇O 2max) does not acknowledge the individual variability of these metabolic boundaries. Moderate intensity physical activity approaches VT1 and LT1 and vigorous intensity physical activity is between the two thresholds (1 and 2). VT2 and LT2 correspond with critical power/speed and respiratory compensation point. There are two key thresholds identified in incremental tests: ventilatory and lactate thresholds 1 and 2, which reflect boundaries related to individualized disturbance to homeostasis that are appropriate for prescribing exercise. The current descriptions of moderate to vigorous intensity are not sufficient, and we wish to enhance understanding of MVPA by recognition of important boundaries that define these intensities. Authorities recommend that we obtain 150min of moderate to vigorous intensity physical activity (MVPA) each week. Intensity of exercise is the most elusive of these elements and yet has important implications for the health benefits and particularly cardiovascular outcomes elicited by regular physical activity. A variety of health benefits associated with physical activity depends upon the frequency, intensity, duration, and type of exercise.
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