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October 11, 2000

Exercise Intensity and Risk of Chronic Disease—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(14):1784-1785. doi:10.1001/jama.284.14.1783

In Reply: We analyzed both intensity and duration of exercise in relation to incidence of stroke. We specifically tested the threshold theory regarding exercise intensity by examining whether there is a dose-response relationship between the MET score and risk of stroke by using a cubic spline. As shown in Figure 1 of our article, there was no indication of a threshold effect within the range of physical activity levels observed among the subjects. While there was a graded relationship between walking pace and risk of stroke (suggesting the importance of exercise intensity in reducing risk of stroke), we also found an inverse association between walking time and risk of stroke, even after adjustment for walking pace. These results suggest that both exercise intensity and duration are important in the relationship of physical activity to chronic diseases.

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