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August 16, 1995

Physical Activity and Public Health

Author Affiliations

Lawrence Berkeley Laboratory Berkeley, Calif

JAMA. 1995;274(7):533-534. doi:10.1001/jama.1995.03530070031016

To the Editor.  —The Special Communication by Dr Pate and colleagues1 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

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