Metabolic Equivalents Intensity Thresholds for Physical Activity Classification in Older Adults

Overview

Journal Eur Rev Aging Phys Act

Publisher Springer

Specialty Geriatrics

Date 2024 May 21

PMID 38773408

Authors

Javier Leal-Martin

Miguel Munoz-Munoz

Miguel Sierra-Ramon

Monica Cerezo-Arroyo

Paola Gomez-Redondo

Luis M Alegre

Ignacio Ara

Francisco Jose Garcia-Garcia

Asier Manas

Affiliations

Soon will be listed here.

Abstract

Background: Although the metabolic equivalents (METs) system is a common procedure to quantify the intensity of physical activity in older adults, it remains unclear whether the conventional METs intensity thresholds (CTs) used for this purpose are appropriate in this population. Therefore, this study aimed (i) to derive overall and fitness-specific METs intensity thresholds in older adults ≥ 60 years old (OATs) expressed both in standard METs (VO/3.5 mL O·kg·min) and older adults METs (VO/2.7 mL O·kg·min), and (ii) to compare them with the CTs.

Methods: A total of 93 subjects were assessed for cardiorespiratory fitness. Graded exercise test protocols using indirect calorimetry were performed to calculate individual VO and categorize subjects as "very poor/fair" or "good/superior" fitness. Overall and fitness-specific OATs expressed in standard METs (OATs) and METs (OATs) were derived based on the %VO and the ventilatory thresholds (VTs) physical intensity categories.

Results: Significantly higher VO, VO at VT and VO at VT (p < 0.001) were obtained in the "good/superior" subgroup compared to the "very poor/fair" fitness subgroup. Accordingly, OATs were approximately 69% higher in individuals with a "good/superior" fitness compared to those with a "very poor/fair" fitness. Furthermore, this study showed that OATs were approximately 21-24% lower than OATs, and 10-22% higher OATs were observed when following the VTs intensity categories (heavy-intensity physical activity [HPA] and severe-intensity physical activity [SPA]) compared to the %VO categories (moderate-intensity physical activity [MPA] and vigorous-intensity physical activity [VPA]). When compared with the CTs, similar or higher OATs and OATs for MPA, and HPA were obtained compared to the conventional MPA threshold (3.0 METs). Conversely, for VPA and SPA, lower, similar, or higher OATs were obtained depending on the METs derivation approach (OATs or OATs) or the intensity categories (VO or VTs), compared to the conventional VPA threshold (6.0 METs).

Conclusions: None of the derived OATs were concurrently similar to the CTs, suggesting that fitness-specific METs intensity thresholds adapted to the METs derivation approach should be used in older adults.

Trial Registration: FenotipAGING (Non-health-care intervention study), PRO-Training (NCT05619250).

Citing Articles

Moderate and Vigorous Physical Activity Intensity Cut-Points for Hip-, Wrist-, Thigh-, and Lower Back Worn Accelerometer in Very Old Adults.

Skjodt M, Brond J, Tully M, Tsai L, Koster A, Visser M Scand J Med Sci Sports. 2025; 35(1):e70009.

PMID: 39753998 PMC: 11698702. DOI: 10.1111/sms.70009.

References

Hupin D, Roche F, Gremeaux V, Chatard J, Oriol M, Gaspoz J . Even a low-dose of moderate-to-vigorous physical activity reduces mortality by 22% in adults aged ≥60 years: a systematic review and meta-analysis. Br J Sports Med. 2015; 49(19):1262-7. DOI: 10.1136/bjsports-2014-094306. View

Noriega de la Colina A, Morris T, Kramer A, Kaushal N, Geddes M . Your move: A precision medicine framework for physical activity in aging. NPJ Aging. 2024; 10(1):16. PMC: 10899613. DOI: 10.1038/s41514-024-00141-9. View

Luhrmann P, Herbert B, Krems C, Neuhauser-Berthold M . A new equation especially developed for predicting resting metabolic rate in the elderly for easy use in practice. Eur J Nutr. 2002; 41(3):108-13. DOI: 10.1007/s003940200016. View

Luan X, Tian X, Zhang H, Huang R, Li N, Chen P . Exercise as a prescription for patients with various diseases. J Sport Health Sci. 2019; 8(5):422-441. PMC: 6742679. DOI: 10.1016/j.jshs.2019.04.002. View

. American College of Sports Medicine Position Stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc. 1998; 30(6):975-91. DOI: 10.1097/00005768-199806000-00032. View

Lansley K, Dimenna F, Bailey S, Jones A . A 'new' method to normalise exercise intensity. Int J Sports Med. 2011; 32(7):535-41. DOI: 10.1055/s-0031-1273754. View

McMurray R, Soares J, Caspersen C, McCurdy T . Examining variations of resting metabolic rate of adults: a public health perspective. Med Sci Sports Exerc. 2013; 46(7):1352-8. PMC: 4535334. DOI: 10.1249/MSS.0000000000000232. View

Willis E, Herrmann S, Hastert M, Kracht C, Barreira T, Schuna Jr J . Older Adult Compendium of Physical Activities: Energy costs of human activities in adults aged 60 and older. J Sport Health Sci. 2024; 13(1):13-17. PMC: 10818108. DOI: 10.1016/j.jshs.2023.10.007. View

Beaver W, Wasserman K, Whipp B . A new method for detecting anaerobic threshold by gas exchange. J Appl Physiol (1985). 1986; 60(6):2020-7. DOI: 10.1152/jappl.1986.60.6.2020. View

10.

Thompson P, Arena R, Riebe D, Pescatello L . ACSM's new preparticipation health screening recommendations from ACSM's guidelines for exercise testing and prescription, ninth edition. Curr Sports Med Rep. 2013; 12(4):215-7. DOI: 10.1249/JSR.0b013e31829a68cf. View

11.

NAGLE F, Balke B, BRANCH B . THE GRADATIONAL STEP TEST FOR ASSESSING CARDIORESPIRATORY CAPACITY: AN EXPERIMENTAL EVALUATION OF TREADMILL AND STEP TEST PROCEDURES. Rep Civ Aeromed Res Inst US. 1964; :1-12. View

12.

Moreno-Cabanas A, Ortega J, Morales-Palomo F, Ramirez-Jimenez M, Alvarez-Jimenez L, Pallares J . The use of a graded exercise test may be insufficient to quantify true changes in V̇o following exercise training in unfit individuals with metabolic syndrome. J Appl Physiol (1985). 2020; 129(4):760-767. DOI: 10.1152/japplphysiol.00455.2020. View

13.

Ozemek C, Arena R . Precision in Promoting Physical Activity and Exercise With the Overarching Goal of Moving More. Prog Cardiovasc Dis. 2018; 62(1):3-8. DOI: 10.1016/j.pcad.2018.12.001. View

14.

Faul F, Erdfelder E, Buchner A, Lang A . Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009; 41(4):1149-60. DOI: 10.3758/BRM.41.4.1149. View

15.

Hall K, Howe C, Rana S, Martin C, Morey M . METs and accelerometry of walking in older adults: standard versus measured energy cost. Med Sci Sports Exerc. 2012; 45(3):574-82. PMC: 5822436. DOI: 10.1249/MSS.0b013e318276c73c. View

16.

Iannetta D, Inglis E, Mattu A, Fontana F, Pogliaghi S, Keir D . A Critical Evaluation of Current Methods for Exercise Prescription in Women and Men. Med Sci Sports Exerc. 2019; 52(2):466-473. DOI: 10.1249/MSS.0000000000002147. View

17.

Parker B, Kalasky M, Proctor D . Evidence for sex differences in cardiovascular aging and adaptive responses to physical activity. Eur J Appl Physiol. 2010; 110(2):235-46. PMC: 2929283. DOI: 10.1007/s00421-010-1506-7. View

18.

Zampino M, Alghatrif M, Kuo P, Simonsick E, Ferrucci L . Longitudinal Changes in Resting Metabolic Rates with Aging Are Accelerated by Diseases. Nutrients. 2020; 12(10). PMC: 7600750. DOI: 10.3390/nu12103061. View

19.

Bentley D, Newell J, Bishop D . Incremental exercise test design and analysis: implications for performance diagnostics in endurance athletes. Sports Med. 2007; 37(7):575-86. DOI: 10.2165/00007256-200737070-00002. View

20.

Garber C, Blissmer B, Deschenes M, Franklin B, LaMonte M, Lee I . American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011; 43(7):1334-59. DOI: 10.1249/MSS.0b013e318213fefb. View