text:
Over the past 35 years, various health associations and agencies in the
United States have published guidelines or recommendations for health
professionals and the public regarding the health benefits and risks of being
physically active. The rationale for these publications was that on the one
hand, many people were insufficiently active and needed guidance on why and how
to become more physically active, but on the other hand, an increase in
physical activity by inactive adults posed significant health risks so medical
guidance was needed. To determine how well various segments of the population
are meeting these guidelines, national public health surveillance systems have
been implemented by agencies within the US Department of Health and Human
Services (HHS). The data collected by these surveillance systems over the past
decade have indicated that many youth, adults, and older adults fail to meet
these recommendations and that the rate of compliance varies substantially by
sex, age, educational achievement, socioeconomic status, and race/ethnicity.
These results are a major reason for an increased emphasis on developing
federal physical activity and public health guidelines and policy statements.
In addition, a majority of the questions now being asked about physical
activity and health relate more to the dose (type, amount, and intensity) of
activity that conveys health benefits in specific populations than to whether
or not there are benefits from being physically active. Thus, it is important
for the review of the science and the development of physical activity
guidelines to carefully consider issues of dose response. This Background
addresses all of these issues by discussing several key issues related to dose
response, presenting an overview of the recent trends in physical activity by
Americans, and outlining the history of physical activity and health
recommendations and guidelines in the United States.
Developing physical activity recommendations for public health would be
quite easy if simply stated answers could be given to such questions as, "How
much activity do I need to be healthy?" or "How much more benefit do I get if I
walk 30 minutes 6 times per week verses just 3 times per week?" Unfortunately
that does not appear to be the case. To provide an appropriate answer to such
questions, a number of issues need to be considered, including a person's
current physical activity status, fitness level, health status, age, sex, and
major health and fitness goals. Genetic differences among individuals also
influence their responsiveness to a specific dose of activity. All of these
issues affect any improvements in health and fitness that may come from
increases in various combinations of type, intensity, duration, and frequency
(the main components of dose).
Some of the body's structures and functions favorably adapt to the
increase in demands placed on them whenever physical activity of a greater
amount or higher intensity is performed than what is usual for the individual.
It is these adaptations that are the basis for much of the improved health and
fitness associated with increases in physical activity. This increase in
activity is called overload and if applied correctly, will improve the
capacity and/or efficiency of various tissues and systems. For example, cardiac
stroke volume and skeletal muscle capillary density are enhanced in response to
an increase in aerobic or endurance activity. Many different combinations of
the main components of dose can achieve this overload. However, too big an
overload applied too quickly can cause fatigue and contribute to injury.
Therefore, the overload needs to be applied progressively in relatively small
increments to allow for the body to adapt before receiving an even greater
overload. This concept is called progression. The nature of the
adaptation, also called specificity, that occurs in response to a
progressive overload is influenced by the type of activity being performed. If
the overload is produced by aerobic activities like walking, jogging, cycling
or swimming, adaptations occur more to the oxygen transport system and various
metabolic processes than if the activity is a resistance activity, such as
weight lifting, which produces greater changes in muscle strength and mass.
Understanding these three principles of the biological responses to activity
overload, progression, and specificity helps in addressing issues
about dose response to activity.
The baseline level of habitual physical activity as well as the exercise
capacity (physical fitness) of a person needs to be accounted for when
considering an increase in physical activity. In other words, it is important
to create an overload but not an excessive amount of overload. Therefore, for a
person who has been sedentary for some time for whatever reason, the initial
dose of activity should be at a relatively low intensity, of limited duration,
with the sessions (also called bouts) spread throughout the week. An example of
this approach would be a walking program with sessions of 5 minutes of slow
walking, 5 to 6 days per week, with the bouts performed at various times
throughout the day (e.g., 3 times per day). As the person adapts to this amount
of activity, the bout duration could be slowly increased to 10 minutes, and as
exercise capacity begins to increase, the walking speed could be increased.
Such an approach is based primarily on expert opinion and clinical experience,
as the benefits and risks of various approaches to initiating and progressing
an activity program for very sedentary or unfit persons have not been
systematically evaluated.
Another issue regarding baseline levels of physical activity is the
apparent gradual decline in the recent decade in "routine physical activity"
for an increasing proportion of the US population. Unfortunately, in the United
States and other developed or developing countries, accurate data are not
available on time trends for the total amount of physical activity performed
throughout the day (energy expenditure for activities of daily living). Recent
reports from objective measures of physical activity using accelerometers for 7
days provide some cross-sectional data on the US population. The results show
that a far higher proportion of the population is inactive than has been
indicated from self-reported estimates of physical activity (1;2). Very similar data have been reported
for adults in Sweden using similar technology (3). We still
need to better understand how the results of physical activity assessment by
new objective measurement methods that can be applied to large populations
compare to data collected by commonly used questionnaires. If the time spent
being physically inactive is continuing to increase among the US
population, it may be that the starting dose of activity will need to be
adjusted downward to accommodate more people with lower exercise capacities. At
the same time, the amount of activity that will have to be added to this lower
baseline to return people to being physically active by current day standards
will have to be increased.
Intensity is a key factor when considering the dose of physical activity
required to achieve specific health and fitness outcomes. Not only does an
increase in activity intensity play a major role in producing many favorable
adaptations, but it also has a key role in the risk of injury during activity.
In most of the studies reviewed for this report, the intensity of physical
activity was expressed either in absolute or relative values.
Absolute intensity refers to the energy or work required to perform
the activity and does not take into account the physiologic capacity of the
individual. For aerobic activity, absolute intensity may be expressed
as the rate of energy expenditure (e.g., kilocalories per minutes, multiples of
resting energy expenditure [METs]) or, for some activities, simply as the speed
of the activity (e.g., walking at 3 miles per hour, jogging at 6 miles per
hour). For resistance exercise, absolute intensity is expressed as weight
lifted or force exerted (e.g., pounds, kilograms). Absolute intensity also can
be classified into categories such as light, moderate, hard, and very hard (Table D.1).
Very Light
Very Hard
VO2max =
12 METs
VO2max =
10 METs
Percent VO2max
VO2max =
8 METs
VO2max =
5 METs
Relative Intensity
Percent 1RM§
*%VO2R percent of oxygen uptake reserve; %HRR
percent of heart rate reserve
¥%HRmax = 0.7305
(%VO2max) + 29.95 (4); values based on 10-MET
Borg Rating of Perceived Exertion 6-20 scale (5)
**%VO2max = [(100%-%VO2R)
METmax-1] + %VO2R; personal communication (6)
§RM = repetitions maximum, the greatest
weight that can be moved once in good form
From: Howley, E. Med Sci Sports Ex. S364-S369, 2001. (7)
Some previous physical activity and health recommendations (8), defined absolute moderate intensity as 3.0 to 6.0 METs and
vigorous intensity as more than 6.0 METs. After carefully reviewing these
classifications, the PAGAC recommends that moderate intensity be defined at 3.0
to 5.9 METs and vigorous intensity as 6.0 or greater METs. This redefinition
means that a number of activities classified as 6.0 METs would now be
considered vigorous intensity rather than moderate intensity. A list of
activities classified as 6.0 METs in the Compendium of Physical Activity (9) is included in Table D.2.
Compendium Code (2000)
Heading (Activity Group)
Activity Description
Conditioning exercise
Weight lifting (free weight, nautilus or universal-type), power
lifting or body building, vigorous effort (Taylor Code 210)
Slimnastics, jazzercise
Teaching aerobic exercise class
Fishing and hunting
Fishing in stream, in waders (Taylor Code 670)
Hunting, deer, elk, large game (Taylor Code 170)
Hunting, pheasants or grouse (Taylor Code 680)
Home activities
Moving furniture, household items, carrying boxes
Home repair
Carpentry, outside house, installing rain gutters, building a
fence, (Taylor Code 640)
Lawn and garden
Chopping wood, splitting logs
Gardening with heavy power tools, tilling a garden, chain saw
Mowing lawn, walk, hand mower (Taylor Code 570)
Shoveling snow, by hand (Taylor Code 610)
Building road (including hauling debris, driving heavy
Coal mining, general
Farming, taking care of animals (grooming, brushing, shearing
sheep, assisting with birthing, medical care, branding)
Forestry, planting by hand
Horse grooming
Shoveling, light (less than 10 pounds/minute)
Using heavy power tools such as pneumatic tools (jackhammers,
drills, etc.)
Jog/walk combination (jogging component of less than 10 minutes)
(Taylor Code 180)
Basketball, non-game, general (Taylor Code 480)
Boxing, punching bag
Drag racing, pushing or driving a car
Paddleball, casual, general (Taylor Code 460)
Softball, pitching
Tennis, doubles (Taylor Code 430)
Wrestling (one match = 5 minutes)
Track and field (high jump, long jump, triple jump, javelin, pole
Pushing plane in and out of hangar
Carrying 16 to 24 lb load, upstairs
Hiking, cross country (Taylor Code 040)
Walking, 3.5 mph, uphill
Water activities
Skiing, water (Taylor Code 220)
Swimming, lake, ocean, river (Taylor Codes 280, 295)
Swimming, leisurely, not lap swimming, general
Winter activities
Moving ice house (set up/drill holes, etc.)
Skiing, downhill, moderate effort, general
NOTE: This table is adapted from The Compendium of Physical
Activities (9).
In contrast, relative intensity takes into account or adjusts
for a person's exercise capacity. For aerobic exercise, relative
intensity is expressed as a percent of a person's aerobic capacity
(VO2max) or VO2 reserve, as a percent of a person's
measured or estimated maximum heart rate or heart rate reserve, or as an index
of how hard the person feels he or she is exercising (rating of perceived
exertion) (10). A percent of maximum heart rate or heart
rate reserve can be used because a near linear relation exists between the
increase in heart rate and the increase in oxygen uptake during dynamic aerobic
exercise. Table D.1 also provides the
classification of physical activity intensity showing the relation between
absolute and relative intensity for aerobic activity and relative intensity for
resistance exercise.
In most experimental studies evaluating the effects of increased
activity on various fitness and health outcomes, intensity is expressed
relative to each person's capacity (e.g., 60% to 75% of VO2max).
However, in nearly all of the large prospective observational studies, physical
activity intensity is expressed in absolute terms (no adjustment made for each
person's exercise capacity). These differences in methodology limit to some
degree direct comparison of dose-response data from these 2 major sources of
evidence. For an activity of a given absolute intensity, such as walking at 3.0
miles per hour (3.3 METs), the relative intensity varies inversely to the
aerobic capacity of the individual. As shown in Figure
D.1, for highly fit people with an aerobic capacity of 14 METs, walking at
3.0 miles per hour has a relative intensity of 24 % (left y-axis) or light
intensity (right y-axis), but for people of low fitness who have only a 4-MET
capacity, the relative intensity is at 83% (left y-axis) or hard intensity
(right y-axis). A similar situation is displayed for a walking speed of 4.0
miles per hour with a MET value of 5.0. Note that it is impossible for people
with a 4-MET capacity to walk this fast for an extended period of time, as the
energy requirement exceeds their aerobic capacity. Standardization of activity
intensity classification is essential for accurately establishing the relation
between intensity and health or fitness outcomes.
Exercise Capacity
3 mph
4 mph
The amount of physical activity performed by a person for a given period
of time is the product of activity duration, absolute intensity, and frequency.
Thus, the amount of activity is one expression of activity dose. For many of
the prospective observational studies cited in this review, the primary
activity exposure is the amount of leisure-time or total physical activity
expressed in minutes or hours per day or week (of moderate, vigorous, or
moderate plus vigorous activity), distance walked or jogged/run per day or
week. Exposure also can be the estimated amount of energy expended expressed in
kilocalories per day or week, kilocalories per kilogram of body weight per day
or week, or MET-minutes or MET-hours per day or week.
In experimental studies, the amount of activity sometimes has been
expressed in these same units but also has been given with the intensity in
relative units along with the frequency and duration of the activity sessions
with no overall amount or volume of activity provided (e.g., 30 minutes at 70%
heart rate reserve [HRR], 5 times per week for 24 weeks). To pool or compare
results across studies and develop generalized conclusions about the benefits
provided with various amounts of physical activity, it was necessary to be able
to compare one expression of the amount of activity with others.
Table D.3 provides this type of information for
walking, jogging, and running over a range in activity intensity from 3.0 to
16.0 METs.
For 2.5 hr/wk (150 min/wk)
For 5.0 hr/wk (150 min/wk)
2.5 - 4.3 mph = walk
5-10 mph = jog/run
kilocalories for
75 kg adult when exercising at the given intensity for either 150 or 300
Note: These are gross energy expenditure values during exercise; thus,
they include the energy expenditure at rest and not just the additional energy
expenditure due to the activity. Kilocalories calculated using 1 MET = 1
kilocalorie per kilogram per hour and rounded to nearest 5 kilocalories. MET
values from Ainsworth and colleagues (9).
Based on data in this table, for 2.5 hours per week of activity at
moderate absolute intensity (3.0 to less than 6.0 METs), a person would have a
range for MET-minutes per week of 450 to less than 900, MET-hours per week of
7.5 to less than 15.0 and, if they weighed 165 pounds (75 kilograms), their
kilocalories of energy expenditure would range from 565 to less than 1,125
kilocalories. If this were achieved by walking at various speeds, the distance
would range from 6.25 to less than 10.75 miles per week. At 5 hours per week of
moderate-intensity activity, the MET-minutes per week would range from 900 to
less than 1,800 and MET-hours per week would range from 15.0 to less than 30.0.
Kilocalories expended by a 165-pound (75 kilogram) adult would range from 1,130
to less than 2,250 and the distance walked would be 12.5 to less than 21.5
The energy expenditure values in Table D.3
are estimated gross values. They include both the energy expenditure required
at rest (1 MET) as well as the added (net) energy expenditure required for
performing the activity. The estimated energy expenditure for a 165-pound (75
kilogram) person at rest for 150 minutes during the week is about 190
kilocalories. If that person instead walked at a 3.0 mile per hour pace for the
150 minutes, his or her estimated energy expenditure during this time would be
about 620 kilocalories, or an increase above rest of 430 kilocalories. However,
if the person jogged at a 6 mile per hour pace for these 150 minutes, he or she
would expend approximately 1,875 kilocalories, or an increase above rest of
about 1,685 kilocalories. Thus, a 165-pound person jogging at 6 miles per hour
for 150 minutes per week would expend approximately 1,255 more kilocalories
than if he or she walked at 3 miles per hour for the same amount of time during
the week. This example demonstrates the substantial increase in energy
expenditure as the intensity of the activity increases. In this example, the
increase in kilocalories while jogging is nearly 4 times greater than
the increase while walking (430 versus 1,655).
Since the 1995 physical activity and public health recommendations
published by the Centers for Disease Control and Prevention and the American
College of Sports Medicine (8) and Physical Activity
and Health: A Report of the Surgeon General published in 1996 (11), national health behavior surveillance systems have
collected cross-sectional information on self-reported compliance with these
recommendations by representative samples of Americans. The major national
public health surveillance systems monitoring physical activity in the US
population include the Behavioral Risk Factor Surveillance System (BRFSS;
http://www.cdc.gov/brfss/), the Youth
Risk Behavior Surveillance System (YRBSS;
National Health and Nutrition Examination Survey (NHANES;
and the National Health Interview Survey (NHIS;
For details regarding the methodologies used by each of these surveys, readers
are referred to their respective websites. These surveys provide snapshots of
participation in selected types or categories of activities by adults and youth
and participation in structured programs of activity, such as physical
education and organized sports in youth. They include measures of inactivity as
well as of activity and, in many cases, include information through 2005. No
surveillance system exists that captures an overall determination of physical
activity performed or the energy expended during activity throughout the day
during work, school, home and self care, commuting, and leisure time.
However, one systematic review of physical activity trends over the past 50
years suggest that declines have occurred in work-related activity,
self-transportation activity, and activity in the home, resulting in overall
decrease in physical activity (12).
The BRFSS is a state-based random-digit dialed telephone survey of the
non-institutionalized US civilian population aged 18 years and older. Beginning
in 2001, BRFSS included biannual questions about leisure-time physical activity
asking whether respondents participated in either moderate- or
vigorous-intensity activity in bouts of at least 10-minute duration. If they
did, respondents were asked to report the frequency and duration of these
activities (13). Participants who reported at least 30
minutes of moderate-intensity activity 5 or more days per week or 20 minutes of
vigorous-intensity activity 3 or more days per week, or both were considered to
be engaged in regular physical activity and to meet current recommendations. In
2005, the prevalence of women reporting that they regularly engaged in physical
activity was 46.7%, which was a relative increase of 8.6% from 2001 (43.0%),
while men increased 3.5%, from 48.0% to 49.7%. For women, a significant
increase between 2001and 2005 was reported in all racial/ethnic groups and all
age and education level categories except for women aged 18 to 24 years (Figure D.2). Among men, significant increases were
observed for the age range 45 to 64 years, non-Hispanic whites, non-Hispanic
blacks, high school graduates and college graduates.
As can be seen in Figure D.2, the
percentage of men who reported being physically active is greater than for
women and steadily declines with age in both sexes. The prevalence at age 18 to
24 years is 60.5% for men and 50.8% for women, but significantly decreases by
age 65 years and older to 43.1% in men and 32.2% in women. For both men and
women, higher levels of education were associated with a higher prevalence of
reporting being physically active, ranging from 35.5% and 34.2% for men and
women who had not graduated from high school up to 52.6% and 49.1% for men and
women who were college graduates. Non‑Hispanic white men and women tend
to have a higher reported prevalence of being active than other racial/ethnic
groups with the largest differences in 2005 being between non-Hispanic white
and black women and between non-Hispanic white men and Hispanic men.
The data presented in Figure D.2 are quite
consistent with self-report data from other national surveys conducted over the
past decade.
HS grad
Some C
C grad
Figure D.3 displays data from the Healthy
People 2010 Database (DATA2010) for men and women combined for selected
measures of physical activity reported annually from 1997 to 2006 (14). Over this period, 30% to 35% of adults reported
participation in moderate- or vigorous-intensity activity sufficient to meet
existing recommendations, and those reporting no leisure time activity remained
in the 35% to 40% range. Neither of these measures showed a consistent trend
over time. From 1997 through 2000, approximately 16% of the adult population
reported performing muscle strength and endurance exercises, with an increase
to about 20% being reported from 2001 to 2006.
No leisure-time physical activity
Regular moderate or vigorous physical activity
Strength and endurance activities
Depending on how the questions are asked and the activity classification
criteria used, responses to the various national physical activity surveillance
systems indicate that 45% to 50% of adults in the US report meeting current
public health recommendations for moderate-to-vigorous physical activity
(defined as moderate-intensity activities [i.e., brisk walking, bicycling,
vacuuming, gardening, or anything else that causes small increases in breathing
or heart rate] for at least 30 minutes per day at least 5 days per week, or
vigorous-intensity activities [i.e., running, aerobics, heavy yard work, or
anything else that causes large increases in breathing or heart rate] for at
least 20 minutes per day at least 3 days per week, or both). About 38% to 40%
report being insufficiently active (defined as doing more than 10 minutes total
per week of moderate- or vigorous-intensity lifestyle activities [i.e.,
household, transportation, or leisure-time activity] but less than the
recommended level of activity). Around 25% report performing no
moderate-to-vigorous physical activity during leisure time (defined as no
physical activities or exercises such as running, calisthenics, golf,
gardening, or walking in the previous month), and approximately 15% are
considered inactive (defined as less than 10 minutes total per week of
moderate- or vigorous-intensity lifestyle activities [i.e., household,
transportation, or leisure-time activity]. Figure
D.4 provides data from the BRFSS for 2001-2005 for all adults combined (13).
"Recommended," "Insufficient," and "Inactive" data comprise one measure,
and responses should sum to ~100%. "No Leisure-Time Physical Activity" is a
separate question, and should not be included with calculations for the
recommended, insufficient, or inactive.
Physical Activity
Based on data from the YRBSS for 2005, 35.8% of high school students
reported meeting current physical activity recommendations (defined as
performing any kind of physical activity that increased their heart rate and
made them breathe hard some of the time (i.e., moderate or vigorous intensity)
for at least 60 minutes per day on 5 or more days of the 7 days preceding the
survey) (5). The reported prevalence of meeting this level
of physical activity was higher in boys (43.8%) than girls (27.8%) and higher
in white (46.9%), black (38.2%), and Hispanic (39.0%) boys than for white
(30.2%), black (21.3%), and Hispanic (26.5%) girls. Prevalence estimates of
meeting current recommendations of at least 60 minutes per day 5 or more days
per week of moderate- or higher-intensity activity ranged from 26.9 to 45.9%
across state surveys (median 33.9) for students in grades 9-12.
The recommended level of physical activity used as a benchmark by the
YRBSS before the 2005 survey was either 20 minutes of vigorous-intensity
activity (activities that make a person sweat and breathe hard) at least 3 days
per week or at least 30 minutes of moderate-intensity activity (activity that
does not cause a person to sweat or breathe hard) on at least 5 days per week.
The percentage of students meeting these recommendations in 2005 was
substantially higher than for the updated 60 minutes per day recommendations:
boys (75.8%) were higher than girls (61.5 %) and white (77.0%), black (71.7%),
and Hispanic (76.0) boys had higher compliance rates than did white (63.3%),
black (53.1%), and Hispanic (62.6%) girls. Students reporting not participating
in any moderate or vigorous intensity activity during the past 7 days was 7.6%
nationwide, with a higher prevalence among girls (11.3%) than among boys (7.9%)
and higher among black (14.4%) than white (8.1%) and Hispanic students
In 2005, 54.2% of high school students reported attending a physical
education (PE) class one or more days per week on an average week they were in
school with a higher percentage of boys (60.0%) reporting yes than girls
(48.3%) and higher percentages of white (58.1%), black (61.7%), and Hispanic
(65.9%) boys reporting yes than white (46.1%), black (50.5%), and Hispanic
(57.5%) girls. The prevalence of attending PE class at least one day per week
varied by state from a low of 25.2% to a high of 94.2%. However, when the
frequency criteria for attending PE class was increased from 1 day per week to
5 days in an average week, the prevalence decreased to 37.1% for boys and 29.0%
for girls, with the variation among states ranging from 6.7% to 60.7%.
Based on data from the various physical activity questions contained in
the YRBSS for 2005, high school boys tend to meet moderate-to-vigorous physical
activity recommendations more frequently than do girls, with this sex
difference being true for white, black, and Hispanic youth. Overall, it appears
that white high school students report being somewhat more active than Hispanic
and black students, but their attendance in PE classes does not appear to be
any different.
Figure D.5 displays the trends for various
indices of physical activity for high school students for the period 1999-2005
collected using the YRBSS (14). Included are the
percentage of students who met the previous recommendations of either moderate-
or vigorous-intensity activity, students reporting no moderate or vigorous
physical activity, and the percentage of students reporting attending PE class
5 days per week on average or at least one day per week. The overall impression
gained from the data displayed in this figure is that over this 7-year period,
neither reported activity meeting moderate-to-vigorous physical activity
recommendations or attendance in high school PE classes changed much. The
prevalence of students not reporting any moderate-to-vigorous physical activity
over the past week also has remained quite constant.
Meet moderate or vigorous physical activity
Physical education class 5 times per week
Physical education class ≥1 time per week
No moderate or vigorous physical activity
As mentioned previously, no national surveillance system in the United
States attempts to document all activity performed throughout the day. Also, no
national surveillance system exists to track physical activity of young
children not yet in high school or to specifically target the rapidly
increasing older population. The results of the national surveillance systems
cited above generally indicate some small changes in the activity status of
youth and adults in the past 5 to 10 years, primarily based on whether or not
they meet current physical activity recommendations. Data from the BRFSS for
2001-2005 do demonstrate a 6% or so relative increase in adults meeting
moderate-to-vigorous physical activity recommendations, and other BRFSS data
for the period 1994-2004 indicate that the percentage of the population who
reported no LTPA decreased from 29.8% in 1994 to 23.7% in 2004 (13). However data collected using the NHIS indicate that the
percentage of adults who engaged in regular leisure-time physical activity did
not change between 1997 and 2006.
Overall, the data provided by these national surveillance programs
consistently demonstrate that a majority of adults do not meet current physical
activity and public health recommendations. Although about two-thirds of high
school students report meeting previous moderate-to-vigorous physical activity
recommendations (at least 30 minutes of moderate intensity activity at least 5
days per week, or vigorous intensity activity at least 20 minutes at least 3
times per week), only 35.8% report meeting the current recommendations (at
least 60 minutes per day of moderate or vigorous intensity activity on at least
5 days per week) (5). Also, any changes in the various
indices of physical activity for high school students have been small and
inconsistent over the past decade.
The use of self-report instruments to monitor physical activity over
time is known to have a variety of limitations given the diversity of
activities that are performed daily by people with different jobs, home care
responsibilities, commuting patterns, and leisure-time pursuits. Attempting to
obtain adequate detail so that accurate classifications of activity status can
be made based on type, intensity, and amount of activity is difficult and can
lead to inaccurate information and increased non-response. Until recently, no
real option existed for collecting physical activity surveillance data other
than by self-report. However, over the past decade, the technology of objective
physical activity monitors, especially accelerometers, that can be used in
large and diverse populations has developed substantially. Initially, these
monitors were used in small-scale studies, but accelerometer data describing
the physical activity patterns in relatively large (n=1,100 to 6,800) samples
(1-3) has recently been published. These initial reports
demonstrate the substantial potential for the use of such devices in national
physical activity surveillance programs but also present a challenge for
analyzing the large amounts of data they produce and interpreting results. For
example, accelerometers were used to collect NHANES data minute by minute
during waking hours over 7 days in approximately 6,800 children, adolescents,
and adults (1). Based on these data, 42% of children aged 6
to 11 years met the current 60 minutes per day recommendation but only 8% of
adolescents met this goal and fewer than 5% of adults met the 30 minutes or
more per day recommendation. These estimates of physical activity participation
are substantially lower than those obtained in nationally representative
surveys by self-report described above. The reasons for the differences are not
clear. One reason may be participant over-estimation of physical activity in
self-report surveys. Alternatively, accelerometers may not be accurately
capturing all reported physical activity for a variety of reasons. Most likely,
some combination of reasons explain the disparity. A much better understanding
of how objective physical activity measurements obtained with currently
available and new instrumentation relate to a variety of health outcomes is
needed before such measurements can be used to inform future physical activity
recommendations and policy statements.
By the late 1960s, a number of individuals and organizations in the
United States had recognized the increasingly sedentary nature of the
population and the negative health and fitness consequences of this decline in
activity, and were promoting their own interpretation of a good or best
exercise program. Data from a growing number of observational and experimental
studies supported the value of being physically active, but no consensus
existed on what programs were most effective and safe. Also, during the early
1960s, death rates from coronary heart disease were still on the rise and few
effective treatments for preventing sudden cardiac death were available. It was
well established that the increased work of the heart during vigorous exercise
could trigger cardiac arrest or myocardial infarction in persons with coronary
atherosclerosis. However, investigators and clinicians lacked an understanding
of the etiology of the atherothrombotic disease process, how to detect it in
at-risk populations, and what types and intensities of exercise were safe. Many
people, including physicians, were very concerned about adults older than age
45 years increasing their physical activity, especially starting a vigorous
exercise program or participating in athletic competition. It was this
combination of concern about the need to promote exercise, but at the same
time, fear that promoting exercise, if not carefully controlled, would cause
many people to experience sudden cardiac death that precipitated the
development of the first physical activity guidelines and recommendations. The
evolution of the guideline process over a 35-year period has been characterized
by attempts to reduce risk while maximizing benefit by providing
clinically-oriented recommendations for patient or "at-risk" populations and by
public health-oriented recommendations for the general public.
By the early 1970s, data from several epidemiologic and experimental
studies demonstrated that physically active persons, including patients with
coronary heart disease (CHD), had better health outcomes than did their less
active counterparts. These data were useful in preparing early guidelines
because the major concern was how to minimize risk while achieving health
benefits. The earliest such guidelines were published by the American Heart
Association (AHA) in 1972 and 1975. The first publication was Exercise
Testing and Training of Apparently Healthy Individuals: A Handbook for
Physicians (16). These guidelines were directed more
at reducing the cardiovascular risk imposed by performing moderate- to
vigorous-intensity exercise, including exercise testing for the "coronary
prone," than at providing information on how to help patients become more
physically active. The authors indicated that available data supported exercise
in the rehabilitation of patients with CHD, but data were still inadequate to
support widespread promotion of exercise for the prevention of CHD. The authors
also advised that the exercise recommendations for the healthy but sedentary
person, particularly for the middle-aged male, "not be arbitrarily formulated"
and that "exercise intensity must be adjusted to individual capacity at the
beginning of the program and regulated periodically during the succeeding
The AHA's second publication, Exercise Testing and Training of
Individuals with Heart Disease or at High Risk for its Development: A Handbook
for Physicians, also focused more on assessment of exercise capacity and
issues of risk than on details of program implementation, and more on
rehabilitation than on secondary prevention (17). The
following quote from the publication is an indication of the clinical approach
taken to exercise guidelines in the 1970s: "Exercise is a therapeutic agent
designed to promote a beneficial clinical effect and, as such, has specific
indications and contraindications and possible toxic or adverse reactions"
(page 24).
During this same time period, several professional organizations and
government agencies began to issue recommendations, guidelines, and position
stands on the importance of being physically active, how much of what types of
activity should be performed, and how best to implement a safe activity plan to
increase health and fitness. In 1973, Exercise and Sport Sciences Reviews
published "The Quantification of Exercise Training Programs," a review of
research on endurance exercise training and cardiorespiratory fitness by
Michael Pollock (18). Much of the information developed
during this review was used by Pollock and colleagues as the scientific basis
for the first American College of Sports Medicine (ACSM) Position Statement on
"The Recommended Quantity and Quality of Exercise for Developing and
Maintaining Fitness in Healthy Adults," which was published in 1978 (19). This Position Statement focused on "developing and
maintaining cardiorespiratory fitness and body composition in healthy adults,"
and its key recommendations were that individuals perform an endurance-type
activity for 15 to 60 minutes, 3 to 5 days per week, at 60% to 90% of heart
rate reserve or 50% to 85% of maximal oxygen uptake. Although reasonably brief
(2.5 pages of text and 90 references), the recommendations in this document
became the mainstay for most exercise professionals and much of the public
wanting to know, "How much exercise is enough?" It is worthwhile noting that
all the references cited in this document were from the field of exercise
physiology, with none from physical activity or behavioral epidemiology.
The ACSM reissued this Position Stand in 1990 and changed the title to
"The Recommended Quantity and Quality of Exercise for Developing and
Maintaining Cardiorespiratory and Muscular Fitness in Healthy Adults" (20). The dose of exercise recommended was quite similar to
the 1978 recommendation, with frequency and exercise mode remaining the same,
session duration changing from "15 to 60" minutes to "20 to 60" minutes, and
intensity changing from "60% to 90% of heart rate reserve or 50% to 85% of
maximal oxygen uptake" to "60% to 90% of maximum heart rate or 50% to 85% of
maximal oxygen uptake or heart rate reserve." A specific recommendation for
enhancing muscle strength was added: one set of 8 to 12 repetitions of 8
exercises, 2 days per week. The statement also indicated that less intensive
exercise might also provide health benefits: "ACSM recognizes the potential
health benefits of regular exercise performed more frequently and for a longer
duration, but at lower intensities than presented in this position statement."
(p. 266).
In 1998, the ACSM published the third edition of its Position Stand,
entitled, "Quantity and Quality of Exercise for Developing and Maintaining
Cardiorespiratory and Muscular Fitness, and Flexibility in Healthy Adults" (21). The primary recommendations for exercise to enhance
cardiorespiratory and body composition remained similar to the 1978 and 1990
recommendations except for a small reduction at the low end of the intensity
range: 55% to 90% of maximum heart rate instead of 60% to 90% or 40% to 85% of
maximal oxygen uptake reserve or heart rate reserve instead of 50% to 85%. This
1998 document also included recommendations for flexibility and adopted the
concept of accumulation from public health recommendations published by the
Centers for Disease Control and Prevention (CDC) and ACSM in 1995 (8). (See the following section for more details on the 1995
CDC/ACSM recommendations.) In discussing "duration of training, the ACSM
Position Stand recommended "20 to 60 minutes of continuous or intermittent
(minimum of 10‑minute bouts accumulated throughout the day) of aerobic
In addition to these Position Stands, the ACSM as well as other
organizations developed publications that provided detailed guidelines for
specialists such as physicians, exercise scientists, physical educators,
physical therapists, coaches, and nurses. These guidelines were intended for
use in providing exercise and fitness evaluations, developing physical activity
prescriptions or plans for individuals or groups, and providing exercise
instruction or leadership for patients and healthy persons. Included in these
documents were the 7 editions of Guidelines for Exercise Testing and
Exercise Prescription published by the ACSM between 1975 and 2005 (10;22-27) and Exercise Standards: A Statement for Healthcare
Professionals from the American Heart Association (28).
Starting in the mid-1980s, various medical and public health
organizations held discussions and published manuscripts on public health
rather than clinical approaches to physical activity for achieving improved
health outcomes (29). For example, CDC's Behavioral
Epidemiology and Evaluation Branch organized a "Workshop on the Epidemiological
and Public Health Aspects of Physical Activity and Exercise" in 1984, in which
experts reviewed the current knowledge base relating physical activity to
health status and identified actions to be taken to increase the activity
status of Americans (30). Ten manuscripts were prepared as
the basis for discussion during the conference, and they were published along
with a conference overview (31). This meeting played a
significant role in setting the stage for the evolution of a public health
paradigm for physical activity over the next decade.
The goal of this effort was to augment or supplement, but not
necessarily replace, the existing exercise-forfitness paradigm promoted
by the ACSM and other organizations by focusing primarily on enhancing physical
fitness or working capacity, either in healthy persons or in the rehabilitation
of various patient populations (32). During this 10-year
period, substantial new data were published, especially from physical activity
epidemiology, which related inactivity to increased risk of several chronic
diseases and the potential protective effects of moderate-intensity, as well as
vigorous-intensity activity. In addition, researchers reconsidered some of the
prior epidemiologic data with respect to the most likely kinds and patterns of
physical activity that were carried out by active people, who comprised some of
the lower-risk groups. The tentative conclusion was that much of this
risk-reducing activity was of moderate intensity (usually considered 3.0 to 6.0
METs) and that it was frequently performed in repeated short bouts. Thus, a
disconnect appeared to exist between the accepted exercise-fitness paradigm,
which emphasized vigorous activity performed in bouts of at least 20 minutes
duration, and the intensity and bout duration that appeared to provide some
protection against selected chronic diseases and all-cause mortality.
For example, the results of some studies indicated that regular walking
or other moderate-intensity activity, or moderate levels of cardiorespiratory
fitness, were associated with reduced rates of cardiovascular disease (CVD) and
all-cause mortality (4;33;34). Also, an increasing number of experimental studies
showed disease risk factors or health-related fitness measures to be
significantly improved in sedentary adults as a result of adherence to a
program of regular walking or other moderate-intensity activity (35-37). During this time, a team of Canadian exercise
scientists organized two major international conferences on Exercise, Fitness
and Health (38) and Physical Activity, Fitness and Health
(39). For both conferences, the goal was to understand the
relationship of physical activity and fitness to major health outcomes, develop
a conceptual model for these relationships, and formulate a consensus
statement. These conferences and publications provided an excellent resource
for the developing consensus that a physically inactive lifestyle is a major
contributor to poor health outcomes throughout the lifespan.
In 1992, in light of the mounting evidence that a sedentary lifestyle
significantly increased the risk of CHD morbidity and mortality, the AHA made
sedentary lifestyle its fourth major CHD risk factor, joining cigarette
smoking, hypertension, and hypercholesterolemia (40). This
statement was the first formal recognition by the AHA that physical inactivity
was a major independent risk factor for atherosclerotic heart disease and that
physical activity could play a role in both primary and secondary prevention of
CHD. This document went beyond recognizing just the benefits of exercise for
heart disease to stating that people of all ages could benefit from a regular
exercise program. It noted that activities such as walking, hiking, swimming,
cycling, tennis, and basketball were especially beneficial if performed at 50%
or more of a person's work capacity and that even low-intensity activities
performed daily could have some long-term health benefits. This statement has
been updated over the years by the AHA but without major changes in the key
statements made in 1992; the most recent update was published in 2003 (41).
Given the influential nature of official position statements or
recommendations by the AHA on heart disease prevention and treatment practices
by the medical community in the United States, the elevation of inactivity to a
major CHD risk factor brought substantial attention to the importance of a
physically active lifestyle. Although this statement indicated the general
nature of the activity that should be performed to help maintain good health,
it lacked specific details regarding program design and implementation.
However, it did indicate that intensities lower than that generally promoted in
the past could provide health benefits.
In 1993, the year following the AHA statement recognizing inactivity as
a major CHD risk factor, the CDC in collaboration with the ACSM, began
developing a document that would provide specific recommendations about the
profile of physical activity that should be performed to promote good health.
To develop this statement, an expert panel was appointed that consisted of
epidemiologists, exercise physiologists, public health professionals, and
health psychologists. The panel was charged with developing a statement
grounded in solid science that would clearly communicate its key messages to
the public and provide a program that could be performed by a large segment of
the general public with a minimal increase in risk. It took 2 years of work by
the panel before Physical Activity and Public Health: A Recommendation from
the Centers for Disease Control and Prevention and the American College of
Sports Medicine was released to the public in 1995 (8). These first public health guidelines on physical activity
and health were the culmination of a decade of work that began in 1984 with the
CDC Workshop on the Epidemiological and Public Health Aspects of Physical
Activity and Exercise.
The approach to physical activity for health taken by these "public
health" guidelines was quite different than prior guidelines primarily based on
the "exercise training" or "clinical" paradigm. The primary recommendation was
that "Every American adult should accumulate 30 minutes or more of
moderate-intensity physical activity on most, preferably all, days of the
week." Because many of the prior recommendations had primarily advocated
vigorous-intensity activity, having moderate-intensity activity as the key
recommendation (even though prior guidelines based on vigorous-intensity
exercise were recognized as still effective) raised many questions by exercise
scientists and practitioners. The idea that substantial health benefits could
be derived from brisk walking was not appreciated by many fitness advocates,
but this recommendation was based on data from a variety of epidemiologic and
experimental studies. Even more controversial was the idea that the activity
each day did not need to be performed continuously for at least 30 minutes, but
could be accumulated throughout the day in bouts of 8 to 10 minutes.
For many years, the idea that the activity needed to be continuous to be
effective had been promoted in programs such as "Aerobics" (42) but without any scientific evaluation. In retrospect, the
recommendation for accumulated bouts appears to have been correct. However, in
1995, the published scientific data supporting this concept was quite limited,
and remains so today. Only several experimental studies had directly compared
the effects of continuous exercise bouts versus exercise accumulated through
bouts of 8 to 10 minutes duration (43-45), and the nature
of data collection in epidemiologic studies made the evaluation of the
accumulation concept difficult, at best, to evaluate.
Following close on the heels of the CDC/ACSM report, the National
Institutes of Health (NIH) convened a consensus conference on "Physical
Activity and Cardiovascular Health" (46). The charge to
this nonfederal, non-advocate 13-member panel representing cardiology,
psychology, exercise physiology, nutrition, pediatrics, public health and
epidemiology was "to provide physicians and the general public with a
responsible assessment of the relationship between physical activity and
cardiovascular health." During the 3-day conference, the panel listened to
reports from 27 scientists on the relationship between physical activity and
cardiovascular health, had open discussions with the presenting scientists and
others in attendance, and held closed deliberations to formulate their
recommendations. The draft recommendations were shared with conference
participants and conflicting views were resolved and a final document
The panel concluded that: (1) most Americans have little or no physical
activity in their daily lives; (2) accumulating evidence indicates that
physical inactivity is a major risk factor for cardiovascular disease; (3)
moderate levels of physical activity confer significant health benefits; (4)
all Americans should engage in regular physical activity at a level appropriate
to their capacity, needs and interests; and (5) children and adults should set
a goal of accumulating at least 30 minutes of moderate intensity physical
activity on most, and preferably all, days of the week.
The panel also recognized that a greater amount and/or intensity of
activity than the recommended minimum would provide greater health benefits for
most people (i.e., dose response) and that cardiac patients should integrate
increased physical activity into a comprehensive program of risk reduction.
Thus, the panel made recommendations highly consistent with the CDC/ACSM
working group in that it emphasized performing moderate-intensity physical
activity (using brisk walking as a benchmark) on most or all days for at least
30 minutes per day, and noted the activity could be accumulated in bouts of at
least 8 to 10 minutes duration. It also recognized that its recommendation was
a minimum, and greater health benefits were achievable by performing greater
amounts of activity or through "vigorous exercise." In other words, the prior
recommendations of vigorous exercise performed for 20 to 30 minutes 3 days per
week still applied.
At the same time the NIH was producing its consensus panel report, the
World Health Organization also issued a report on the health benefits of
regular activity (47). The major recommendations in this
document were very consistent with recommendations made by the CDC/ACSM working
group and the NIH consensus panel, namely that a target for all adults should
be 30 minutes or more of moderate-intensity physical activity on most days. The
WHO report also stated that daily physical activity should be the cornerstone
for a healthy lifestyle throughout the lifespan; that more vigorous exercise,
such as slow jogging, cycling, field and court games, and swimming, could
provide additional health benefits; and that people with disabilities or
chronic disease had a great deal to benefit from an individualized activity
program. While recognizing that the responsibility for personal health
decisions ultimately lies with the individual and family, policy
recommendations for increasing physical activity were included in the report as
well for major government organizations.
The CDC/ACSM, NIH, and WHO reports on physical activity and health, all
published in 1995 and 1996, set the stage for the publication of Physical
Activity and Health: A Report of the Surgeon General in 1996 (11). This report was commissioned by the Secretary of Health
and Human Services in 1994 and authorized the CDC to be the lead agency for its
development with collaboration from a number of federal organizations,
especially the President's Council on Physical Fitness and Sports and the NIH.
Non-government collaborating organizations included the ACSM, AHA, and the
American Association of Health, Physical Education, Recreation and Dance. This
was an extensive undertaking, and approximately 195 people contributed to
writing, editing, reviewing, and publishing the report.
The stated goal of the Surgeon General's report was to summarize the
existing literature on the role of physical activity in preventing disease and
on the status of interventions to increase physical activity. It provided an
historical background on the relation of physical activity to health, including
the evolution of physical activity guidelines, looked at patterns and trends of
physical activity in different populations in the United States, and described
various projects to promote increased physical activity in youth and adults. It
also summarized information on acute and chronic physiological responses to
exercise and provided a systematic review of the effects of physical activity
on major health outcomes. The report grew out of an emerging consensus among
investigators and providers working in exercise science, epidemiology, public
health, clinical medicine, health psychology, and education that the high
prevalence of sedentary behavior among the American population was having a
significant negative health impact, that a moderate amount and intensity of
physical activity in this sedentary population could provide important health
benefits, and that innovative, long-term programs were needed to reverse the
continuing downward trend in physical activity.
The key recommendation from the Surgeon General's report was that people
of all ages could improve the quality of their lives through a lifelong
practice of moderate-intensity physical activity: "A regular, preferably daily,
regimen of at least 30 to 45 minutes of brisk walking, bicycling, or even
working around the house or yard will reduce the risk of coronary heart
disease, hypertension, colon cancer and diabetes." A second key message was
that "more is better." People already performing a moderate level of activity
would benefit even more by increasing the intensity and/or duration of their
activity. Both the CDC/ACSM report and the report by the Surgeon General have
been cited frequently in the professional literature on physical activity and
health, and the key recommendations, usually with no or only minor
modifications, have been adopted by national agencies in a number of other
To help assess the information available on the dose of physical
activity needed for specific health outcomes, an international "consensus
symposium" was held at Hockley Valley, Ontario, Canada in 2000 (48). The goal of this evidence-based symposium was to provide
a comprehensive review of the existing science relating physical activity dose
to health and to make specific recommendations regarding physical activity
dose. The major conclusion regarding the dose-response relation for specific
outcomes was that the available data were still inadequate to define any
precise relation. However, the consensus panel did endorse the recommendations
made in the CDC/ACSM report (8) and the Surgeon General's
report (11).
In 2002, the Institute of Medicine (IOM) published a report primarily
focusing on macronutrient intake and energy intake and expenditure. The report
developed estimates of daily intake that are compatible with good nutrition
throughout the life span and that may decrease the risk for chronic disease (49). The preparation of this report by the IOM, a private
nonprofit organization and component of the National Academy of Sciences, was
funded by HHS, the US Department of Agriculture (USDA), the US Department of
Defense, and Health Canada. The panel considered the level of macronutrient,
and thus caloric intake, consistent with good health and the caloric
expenditure needed to keep people in a healthy weight range, defined as a body
mass index (BMI) of 18.5 to 25.0 kg/m2. For people to achieve these
goals, the panel concluded the following regarding physical activity:
"Physical activity promotes health and vigor. Cross-sectional data from
a doubly labeled water database were used to define a recommended level of
physical activity, based on the physical activity level (PAL) associated with a
normal body mass index (BMI) range of 18.5 to 25 kg/m2. In addition
to the activities identified with a sedentary lifestyle, an average of 60
minutes of daily moderate intensity physical activity (e.g., walking/jogging at
3 to 4 miles/hour) or shorter periods of more vigorous exertion (e.g., jogging
for 30 minutes at 5.5 miles/hour) was associated with a normal BMI and
therefore is recommended for normal-weight individuals. This amount of physical
activity leads to an 'active' lifestyle, corresponding to a PAL greater than
1.6 (see Chapter 5). Because the Dietary Reference Intakes are provided for the
general healthy population, recommended levels of physical activity for weight
loss of obese individuals are not provided." (p.880).
Upon the release of this report, many in the press, general public, and
health professions considered that the report had articulated a significant
change in physical activity recommendations for health, with the target now
being 60 minutes of moderate-intensity activity daily rather the 30 minutes or
more that had been promoted since 1995. However, it is very important to
understand that the prior recommendations by CDC, ACSM, NIH, and HHS were based
primarily on the amount of physical activity shown to be consistent with lower
morbidity and mortality rates from selected chronic diseases and all-cause
mortality, and not on the amount for achieving an optimal BMI of 18.5-25.0
kg/m2, which was the major goal of the IOM report. Also, in the IOM
report, the 60-minute recommendation was made in order to achieve all
the identified health benefits fully, while in the other reports, the 30 or
more-minute recommendation was considered a minimum. The other reports
acknowledged that more exercise would bring additional benefits. As with the
prior reports, the IOM document indicated that activity could be accumulated
throughout the day and did not need to be performed only in a single
A key difference in the data considered during the formulation of the
IOM recommendation versus other previous physical activity recommendations was
the IOM panel's emphasis on doubly-labeled water studies. Combining data from
available doubly-labeled water studies, the panel estimated the total daily
energy expenditure of men and women who had a BMI of 18.5 to 25.0
kg/m2. They determined that these subjects had an average PAL of
about 1.75. The panel then took the PAL of people considered to be sedentary
(1.25) and that of people considered to be of normal weight (1.75) then
calculated the difference in PAL between people who were sedentary and those
who were normal weight and converted this to minutes per day of
moderate-intensity activity. Not taken into this consideration was the fact
that the PAL for the subjects in the doubly-labeled water studies who were
overweight or obese was not 1.25 but in the 1.59 to 1.85 range (50). These cross-sectional data do not deal with the question
of how much added exercise will produce a meaningful change in body weight.
The IOM selection of a target activity level of 60 minutes per day or a
PAL of 1.6 or greater to maintain optimal body weight is somewhat less than the
target PAL of 1.75 in the 1998 report by the World Health Organization,
Obesity: Preventing and Managing the Global Epidemic (51). In this extensive report, the authors stated that
analyses of more than 40 national physical activity studies worldwide show a
significant relationship between the average BMI of adult men and their PAL,
with the likelihood of becoming overweight being substantially reduced at PALs
of 1.8 or above. For women, the PAL associated with a healthy weight was
approximately 1.6. Therefore, the WHO report suggested "that people should
remain physically active throughout life and sustain a PAL of 1.75 or more in
order to avoid excessive weight gain" (p.124).
In 2002, an international group of scientists with expertise in physical
activity, nutrition, energy balance and obesity held a consensus meeting
convened by the International Association for the Study of Obesity to assess
"how much physical activity is enough to prevent unhealthy weight gain" (52). Part of their conclusion was that, "The current physical
activity guideline for adults of 30 minutes of moderate intensity activity
daily, preferably all days of the week, is of importance for limiting health
risks for a number of chronic diseases, including coronary heart disease and
diabetes. However, for the prevention of weight gain or regain this guideline
is likely to be insufficient for many individuals in the current environment.
There is compelling evidence that prevention of weight regain in formally obese
individuals requires 60 to 90 minutes of moderate intensity activity or lesser
amounts of vigorous activity. Although definitive data are lacking, it seems
likely that moderate intensity activity of approximately 45 to 60 minutes per
day or 1.7 PAL is required to prevent the transition to overweight or obesity"
(page 101). This consensus statement recognized that the amount of physical
activity associated with lower chronic disease mortality rates is very likely
less than that needed in the current environment to prevent unhealthy weight
gain or regain in many adults.
Every 5 years, the USDA and HHS are required by the US Congress to
prepare Dietary Guidelines for Americans. The Guidelines published in
1995 and 2000 recognized that a physically active lifestyle should be
maintained for optimal health, but no specific guideline focused on prevention
of weight gain or weight loss. For example, in 2000 the recommendations were
highly consistent with the 1995 CDC/ACSM report directed to improving general
health status: "Aim to accumulate at least 30 minutes (adults) or 60 minutes
(children) of moderate intensity activity on most days of the week, preferably
daily. If you already get 30 minutes of physical activity daily, you can gain
even more health benefits by increasing the amount of time you are physically
active or by taking part in more vigorous activities. No matter what activity
you choose, you can do it all at once, or spread it out over two or three times
per day" (53), p.10.
The 2005 Dietary Guidelines for Americans structured the
physical activity recommendations to separate advice about chronic disease
prevention from advice about the amount of physical activity required for the
prevention of unhealthy weight gain or regain or achieving weight loss in
adults (54). They took the generally accepted position
that a variety of health benefits are derived from at least 30 minutes of
moderate-intensity exercise on most days, and separated this recommendation
from the less well documented and understood recommendations regarding the
amount of physical activity required to prevent unhealthy weight gain or regain
and weight loss. The physical activity recommendations needed to help manage
body weight were adopted in large part from the 2002 IOM report (49), which had primarily considered cross-sectional data from
doubly-labeled water studies of energy expenditure (55).
To help adults manage body weight and prevent gradual unhealthy weight gain,
the Guidelines recommended approximately 60 minutes of
moderate/vigorous activity on most days of the week (while not exceeding
calorie requirements). To help adults lose weight and to sustain weight loss,
the Guidelines recommended at least 60 to 90 minutes of daily
moderate-intensity physical activity daily (while not exceeding calorie
requirements). These two recommendations regarding weight gain prevention and
weight loss received the most attention and contributed to some confusion among
the public.
In 2002, the ACSM and CDC organized an expert panel to consider whether
the 1995 CDC/ACSM physical activity and public health recommendations needed to
be updated (8). Key reasons for this consideration included
new scientific evidence since 1995 relating physical activity to health,
physical activity recommendations by various organizations in the interim that
appeared to be in conflict with the 1995 recommendations, and communications
issues related to certain terminology used in the 1995 report. The panel
decided that an update would be of value to health professionals and the
public, and two writing groups were formed, one to prepare recommendations for
adults (18 to 65 years) and another for older adults (older than 65 years). The
purpose of these reports was to update and clarify the 1995 recommendations on
the types and amounts of physical activity needed by healthy adults and older
adults to improve and maintain health. These groups reviewed advances in
pertinent physiologic, epidemiologic, and clinical scientific data, including
primary research articles and reviews published since the original
recommendation was issued in 1995.
The writing groups prepared the two manuscripts, intending that the
recommendations would represent an update from CDC and ACSM. However, after
extensive review at CDC and HHS, it was decided that because physical activity
recommendations for adults had been published as part of the 2005 Dietary
Guidelines for Americans that CDC should not issue additional physical
activity recommendations. ACSM representatives then asked the AHA to
participate in issuing the updated recommendations, and the two sets of
recommendations were published in 2007 (56;57). No major changes were made in the recommendations either
for adults or older adults but a number of features about the type and amount
of activity most likely to provide various benefits were clarified. Also,
issues regarding the role of physical activity in body weight management were
addressed and resistance exercise was made part of the core recommendation for
all adults.
Primary recommendations for adults included the following:
The recommendations for older adults are very similar to the updated
ACSM/AHA recommendations for adults, but have several important differences.
For example, the recommended intensity of aerobic activity takes into account
the older adult's aerobic fitness, activities that maintain or increase
flexibility are recommended, and balance exercises are recommended for older
adults at risk of falls. In addition, older adults are encouraged to have an
activity plan for achieving recommended physical activity that integrates
preventive and therapeutic recommendations. The promotion of physical activity
in older adults places more emphasis on moderate-intensity aerobic activity,
muscle-strengthening activity, reducing sedentary behavior, and risk
[1] This overview of the
development of physical activity guidelines in the United States was adapted
from a chapter prepared by W. Haskell for Epidemiologic Methods in Physical
Activity (15). Its use in this report was approved by
the publisher.
Continue to E. Integration and Summary of
the Science
Back to C. Key Terms
to Physical Activity Guidelines Advisory Committee
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text:
Don't invite the FBI to your vegan potluck
I know it is that time of year and everyone is all stoked on Spring and being vegan and spreading the love, but you have to be sure not to invite the FBI. I know you want as many people as possible and that your hummus is bangin and that you have just the right flyer to convert each and every person to veganism. But remember, the FBI wants to come to your vegan potluck. A vegan FBI agent is still an FBI agent.

subset: commoncrawl


text:
Brookhaven sued over pine barrens credit system
A Nesconset lawyer has sued the Town of Brookhaven and the Central Pine Barrens Commission over alleged violations of the Pine Barrens Act.
The state law was passed in 1993 to protect the region's 100,000-acre pine forest and nearby drinking water aquifer by severely restricting development. A system was proposed as a way to compensate landowners in the core of the pine barrens by allowing them to sell development credits for designated areas where development is permissible elsewhere in the region, since they couldn't develop their own properties.
But zoning and land use attorney Richard Scheyer said the town's anti-development stance and failure to establish receiving areas have rendered the credits virtually worthless. "By never designating areas, they're keeping people from building," he said.
Scheyer, who represents the land use company Pluralis LLC and its principal Robert Toussie, filed suit in Suffolk Supreme Court Wednesday. He said the credits awarded landowners in the pine barrens core have no value because there's nowhere in Brookhaven to sell them for development.
He said Toussie and Pluralis own 95 credits. The average price for a pine barrens credit in Brookhaven has fallen from a 2005 peak of $116,250, according to pine barrens commission records. The most recent sale was in January when 0.23 of a credit was sold for $18,400, which works out to be $80,000 per credit.
The suit seeks compensation for what Scheyer claims is $20 million in "value lost to pine barrens credit holders," though Scheyer said his client is not seeking monetary gain.
"What the suit is about is to compel the pine barrens commission . . . to enforce the law," Scheyer said, accusing the town board for NIMBYISM. "By ignoring the law, it's hurting a lot of people, including low-income housing. The net result is for political reasons they didn't want the increased [housing] density anywhere in their own areas, but they signed onto a law that said they were going to provide it."
Town attorney Annette Eaderesto said Brookhaven officials had not been served the lawsuit by Wednesday afternoon, but based on a description provided by Newsday, she said, the lawsuit was "inartfully crafted litigation that may be susceptible to [a] motion to dismiss."
She said the lawsuit "lacks necessary parties and may not have been brought in the appropriate venue," and added "we will defend this vigorously."
Calls to the Central Pine Barrens Commission were not returned Wednesday.
Pine barrens advocate Richard Amper, of the Long Island Pine Barrens Society, said the lawsuit inaccurately presumes the town will not designate receiving areas. "There are more than sufficient receiving areas for the use of existing pine barrens credits," Amper said. "The case is premature."Mitch Pally, chief executive of the Long Island Builders Institute, said his group plans to support Scheyer's lawsuit. "For the last 20 years the town has been, the belief is, in violation of the pine barrens statute because of the lack of mandatory receiving areas," Pally said. "We clearly agree in context that the town lacks the appropriate necessary receiving areas under the statute."
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I hope someone called Duckling Protective Services, because this is really just terrible timing to take the kids out for a swim. She's probably Canadian.
During Friday practice for this weekend's events at Belle Isle, Detroit, mama duck led her five little ones across the straightaway. They miraculously made it to the wall, but couldn't get over it—so they started weaving back and forth across the track as cars zoomed by. Finally the yellow flag came out, and track workers escorted the wayward waterfowl to safety.
Stupid ducks.


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We're a little bit of Sweden in the UK for you.We sell Swedish food & products.
Garland 4m.
London Marylebone 32 Crawford StreetW1H 1LS
Tel 020 7224 9300
Opening hrsMon–Wed: 10:00-18:00Thu: 10:00-19:30Fri-Sat: 10:00-18:00Sun: 12:00-16:00
London Barnes66 Barnes High StreetSW13 9LD
Tel 020 8487 2882
Opening hrsMon–Sat: 9:30–17:30Sun: Closed
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Monday, 12 March 2012
Sketchbook Pro Brush Settings
15 comments:
- jake gumbleton said...
You are a generous old soul! Can you upload your brain too so we can all use that on our work too? Loving your recent updates.
How are you getting on with freelancing?
- 12 March 2012 at 11:32
- Army Artist said...
Thank You! Its was like Christmas when I got home from work and found that you shared your brush settings thank you. I have spent hours trying to emulate your brush. Now I must get back to play. Again Thank you.
- 12 March 2012 at 23:51
- PRADIP INGALE said...
You are true soul... ther are rare people who are great artist and great human being....Thanks
- 13 March 2012 at 05:53
- Omen D4 said...
Come over here and pucker up you beautiful man. I hope all that vodka doesn't go to your Wacom. Cheers fella
- 15 March 2012 at 20:58
- Borilius said...
Thank you, good sir! Now i have a brand new set called "CAW Brushes"! Wish i had the skill too ;)
- 20 March 2012 at 11:37
- Massimo said...
Thank you so much! That is so very generous of you! And keep up the marvellous work!
- 20 March 2012 at 13:59
Oh man, this changed the game with Sketchbook Pro for me. Thanks so much for posting these. Fantastic.
- 28 March 2012 at 07:59
- Iñigo Rotaetxe said...
Thank you so much, you are so inspiring and generous. Your post has definitively made me try sketchbook, and start to enjoy it so much.
Congratulations for your wonderful work master.
- 6 May 2012 at 17:15
muchisimas gracias!
por vuestra generosidad
thank you very much for your
- 5 August 2012 at 00:36
- Dramiro said...
Hi Man,
You brushe old pencil it's based on the pen or the eraser?
- 20 August 2012 at 10:49
- 4 November 2014 at 01:11
- shikanglu said...
Thanks for these great Brushes! Never had such a natural feeling, when drawing on my Wacom...
BTW, do you have any suggestions, how to emulate "Watercolor-bleeding"? Because I saw some nice Sketches of you, using it, on your Portfolio.
- 3 March 2015 at 11:41
- Alina John said...
Now you can be a sketch pro! Create fun doodle videos yourself, learn about easy sketch pro review here
- 4 July 2015 at 17:02
- JavaPunk00 said...
How can I get these brushes?
- 7 March 2016 at 21:10
- Desga said...
Sketchbook Pro Mac Crack Latest Version Key
- 7 March 2018 at 14:03


text:
|Topic Review (Newest First)
|Jan 6th, 2013 07:37 AM
|ma re
Re: Marija Abramovic
Yes, she was doing good last year, but played very little towards the end of the season and the reason is probably her poor form at the time, so she probably decided to give it a rest and save money for 2013. It's a shame cause she had a really good year and reached her career-high rankings in both singles and doubles in late Spring, but then things started falling apart. She fell in the rankings considerably, especially so in doubles where she is more than 150 spots away from where she was just 6 months ago. She obviously showed that she is capable of good tennis, and it wouldn't surprise me to see her in some Slam qualies this year (maybe doubles too), but it's a big job ahead if she wants to make it. RG cut-off is less than 5 months away and her singles ranking is some 80 spots (and about as many points) from where she needs to be to make it. Hope we hear some good news from her soon.
|Jan 6th, 2013 03:23 AM
Re: Marija Abramovic
Wheres Marija?? Was making some good gains
|Sep 28th, 2012 07:15 AM
|ma re
Re: Marija Abramovic
Since we last spoke of her Maria hasn't done much in either singles or doubles. There are rare exceptions like a close, three set QF defeat in the doubles of Albuquerque 75k to eventual finalists Falconi/Sanchez, where Maria played in an unseeded team with Amra Sadikovic. She failed to defend quite a few points from last year in the past 3 months, so her ranking slid some 50 places in singles and 40(ish) in doubles.
This week, in 50k Las Vegas, she did an excellent job of taking out the 5th seed Falconi in straight sets but then failed to take her chance by losing to a 20 y.o. qualifier Perez, who is ranked just a few spots higher than Maria. In doubles she again teamed up with Sadikovic and they again won a round (again as an unseeded team), scraping a tough one against wild-cards Burdette/Embree, but then ran into the top seeded Rodionovas and went down in straights.
All in all, Maria is showing signs of improvement from the past few months, but she is defending quite a few doubles points in the next 3 weeks - a 50k title, a 50k semi and a 25k title On top of that, there's a 50k QF in singles, coming up in late October.
Busy weeks ahead. Best of luck Maria!
|Jun 11th, 2012 01:43 PM
|ma re
Re: Marija Abramovic
Wonderful stuff from her recently! Given the fact that she is playing on clay this week I'm guessing she has no plans for Wimbledon (haven't even checked the entry lists), but if she can continue like this for a few more weeks nice things might be in store for her in New York!
Good luck!
|Jun 11th, 2012 01:26 PM
Re: Marija Abramovic
This week Maria reaches CH rankings in singles (266) and doubles (141).
|May 19th, 2012 11:50 AM
Re: Marija Abramovic
50k SF is great result!
|May 19th, 2012 10:16 AM
|ma re
Re: Marija Abramovic
It's a shame, but still a very good week
|May 19th, 2012 09:35 AM
Re: Marija Abramovic
SF: Zheng S. - Abramovic 63 62
|May 18th, 2012 10:41 AM
Re: Marija Abramovic
That's awesome!
|May 18th, 2012 09:26 AM
|ma re
Re: Marija Abramovic
|May 18th, 2012 08:37 AM
Re: Marija Abramovic
Maria ABRAMOVIC (CRO) def. Aiko NAKAMURA (JPN) [8] 7-6 4-6 6-4
Maria in the SF of a $50K
She'll reach a new CH ranking next week. I'm sure she has been wanting this badly. Her current CH ranking is from four and a half years ago!
|May 17th, 2012 08:55 AM
|ma re
Re: Marija Abramovic
Great job Ivana, what a match-up in the quarters! Love the way she is climbing the doubles ranks as well!
Good luck!
|May 17th, 2012 07:41 AM
Re: Marija Abramovic
^ Maria reached a new CH ranking in doubles this week: #143.
This week she's playing another $50K in Japan. The bad news is she lost in R1 of doubles. The good news is that she's in the singles QF:
1st Round: Maria ABRAMOVIC (CRO) 4-6 6-1 6-4 Akiko YONEMURA (JPN)
2nd Round: Maria ABRAMOVIC (CRO) 6-2 6-0 Riko SAWAYANAGI (JPN)
In the QF she plays the #8 seed, Nakamura (#247 but CH #47 ). Good luck, Maria!
|May 11th, 2012 10:02 PM
Re: Marija Abramovic
Maria is in the doubles SF of $50K Fukuoka. She and her partner are unseeded. In the SF they play another unseeded team:
1st Round: Maria ABRAMOVIC (CRO) / Remi TEZUKA (JPN) 6-3 5-7 [10-8] Samantha MURRAY (GBR) / Emily WEBLEY-SMITH (GBR)
Quarterfinal: Maria ABRAMOVIC (CRO) / Remi TEZUKA (JPN) 3-6 6-1 [10-2] Wan-Ting LIU (CHN) / Yi-Fan XU (CHN) [4]
Semifinal: Maria ABRAMOVIC (CRO) / Remi TEZUKA (JPN) v Misa EGUCHI (JPN) / Akiko OMAE (JPN)
One more win would for sure give Maria a new CH doubles ranking. Good luck!
|Apr 18th, 2012 10:32 PM
Re: Marija Abramovic
Originally Posted by networthy View Post
^ Thanks for the pics
Frustrating that in qualies Maria destroyed the top seed Bona (#240) 61 60 only to lose in R1 to another qualifier, #8 seed Pereira (#291)
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Core Regulator
This kit provides a universal way to improve A/C efficiency and gas mileage in any vehicle.
In a car, the heater core is a radiator-like device used in heating the cabin of a vehicle. Typically, the heater core receives a constant flow of coolant from the engine. Even when the temperature controls are set to the max A/C position, there is residual heat in the plenum box due to this constant flow of warm coolant. That residual heat causes the A/C compressor to work harder, and uses more fuel. At the same time, it mixes with the cool air and causes passengers to experience less than optimal A/C.
Our kit allows users to control this flow of coolant from the engine to the heater core, and manage the amount of residual heat produced by the heater core. This is particularly useful in the summertime, when many users desire maximum A/C output and do not plan on using the heater at all.
By installing our kit in-line with the heater core, users will be able to remove the residual heat from the heater core, feel cooler air in the max A/C mode, minimize the running time of the A/C compressor, and increase fuel efficiency as well.
The HeaterTreater blend door repair kit is the optimal solution for a broken blend door on many vehicles. However, many vehicles have difficult-to-access plenum boxes, making our standard repair incompatible. The Core Regulator is a product designed to solve the broken blend door problem for virtually any vehicle. This is accomplished by bypassing the blend door and regulating the heat with a switch (which controls the flow of hot coolant from the engine to the heater core), thereby saving the $1000+ repair charge to install a new plenum box.
This is a product from HeaterTreater that can be used universally on almost any automobile. There are multiple applications that are listed below. The kit provides an electronically controlled valve that allows you to turn the flow of coolant through the heater core on and off. This can be used for either temperature control or AC efficiency optimization. We are adding pictures and information on different vehicles and will offer rebates for information feedback.
We are in the business of providing replacement blend doors for multiple vehicles. Our repair method includes cutting into the plenum box and extracting the broken door and replacing it with one of our metal assemblies. This is the preferred repair method for most vehicles, however, we find that a lot of vehicles have limited or no access to the blend door without complete removal of the plenum box. This kit is applicable for vehicles that are difficult or impossible to repair without complete disassembly of the dash and can actually be used on any vehicle.
As shown in the computer animation, the temperature of the air flow is regulated by a combination of cutting the AC compressor on and with the new HeaterTreater valve, cutting the flow through the heater core on and off. For AC, the heater core is cut off and is a neutral element in the system. All air now flows through the heater core and can be cooled by cutting on the AC compressor or just ambient air on a pleasant day. For heat the AC compressor is cut off and the heater core is switched for hot radiator fluid to flow through the core and provide heat in the system.
All of the AC functions will operate with the same AC control panel and will operate just as before the HeaterTreater installation. You won't have the ability to warm up the AC by moving the blend door and letting some air flow through the hot core to "warm" up the AC, but the system will regulate temperature by cutting the compressor off if the air is too cold. It's actually inefficient to cool then warm air and it will be a gas saving method to run the AC.
The heat in the vehicle will be a little different control method. Generally the core will get to temperatures upwards of engine operating temperatures and most humans aren't comfortable at 200 degrees F. We've all started out on a cold morning with full heat and find that we need to cut back once the engine reaches operating temperature. The temperature is cut back by moving the blend door and mixing hot air with ambient air to reach a comfortable temperature. Without the blend door operating, the temperature has to be controlled with the following methods:
• Cut the fan speed down to blow less air through the core and out of the vents.
• Set the air intake to outside air to bring in frigid air rather than re-circulate internal air.
* Use a hose clamp to restrict water flow on the heater hose to cut down the max temperature attainable in the heater core.
• Cut the flow of fluid through the heater core off such that it cools down and doesn't heat the air to full engine temperature. Cut it back on when it gets too cold.
• Last resort, roll the window down a little…
This is basically the way temperature was controlled in the 40's and isn't at all difficult, just takes a little knowledge of the system and more "human" control rather than "computer" control. Just tell yourself that you're smarter than the computer anyway…
The disadvantage of this installation is that you don't have the same level of automated control over temperature and there is a little learning curve to getting the right temperature. The advantages are:
• You are removing a source of heat from the passenger compartment, improving AC efficiency in the summer. It's hard to measure the difference since AC temperature is dependent on engine temperature, fan speed, compressor on/off cycle, blend door position. We attempted to measure the AC operation difference, but in normal in-town driving the results were erratic. We ran another experiment at steady highway speeds with everything at steady state operating conditions and measured a 7 degree difference in cabin temperature with the HeaterTreater system installed. We can't guarantee these results, but just taking heat out of the passenger compartment WILL help AC.
• This is a much cheaper repair than taking the vehicle to a mechanic and paying for the vehicle to be disassembled, replace with another plastic blend door, and putting it all back together, about 10hrs labor at going rates around $100/hr.
• You actually improve mileage and fuel economy slightly since you will run the AC compressor at a lower frequency when it doesn't have to cool both you and eliminate the radiant heat from the heater core. Approximately 2-4% of engine cooling is through the heater core and radiant heat distributed into the passenger compartment. This heat now stays outside the cabin. It's actually a "green" step for your vehicle.
Dodge Durango and Dakota
Mercury Marquis and Ford Crown Victoria


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Talk:Tips for Getting Around Seattle
From Midwinter2007
Is there any chance the official ALA midwinter site will get updated with the public transportation information? The official site implies the $2.50 pass is available any day.
Midwinter Meeting Website Editor Response: Thanks for the heads up. It appears I copied the information into the ALA Midwinter website incorrectly. My apologies. I've corrected it. In the future, if you see errors on the ALA site, please email the admin at the bottom of the page to get them fixed quickly. Thanks!


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Debra Medina, a nurse and Tea Party activist running for the Republican nomination for governor in Texas, has had a recent surge in popularity thanks to heavy promotion by the Tea Party movement. She is even further to the right than current Gov. Rick Perry (R) and has spoken at pro-secession rallies, saying "we are aware that stepping off into secession may indeed be a bloody war." Today on Fox News host Glenn Beck's radio show, Medina took her right-wing lunacy to new heights:
BECK: Do you believe the government was any way involved with the bringing down of the World Trade Centers on 9/11?
MEDINA: I don't, I don't have all of the evidence there, Glenn. So I don't I'm not in a place, I have not been out publicly questioning that. I think some very good questions have been raised in that regard. There are some very good arguments, and I think the American people have not seen all of the evidence there. So I've not taken a position on that.
Listen here:
Beck immediately tried to distance himself from Medina. As soon as she hung up, he said, "I think I can write her off the list." On his website, Beck said the "shocker" was "not good." Medina herself walked back from the comments, writing on her website that she was "surprised" by the question and that "there is no doubt in my mind that Muslim terrorists flew planes into those buildings." She added that the "real underlying question here, though, is whether or not people have the right to question our government."


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Brazil gears up for South American Boys' U17 South American Championship
Rio de Janeiro, Brazil, November 29, 2013 - The Volleyball Development Centre (CDV) in Saquarema, Rio de Janeiro, will hold the second South American Boys' U17 South American Championship from December 4 to 7.
Hosts Brazil who are also the current championship title holders, will face Argentina, Chile, Colombia, Paraguay and Uruguay in the competition.
In Saquarema, Rio de Janeiro, all six teams will face each other once in the classification stage with the top four advancing to the semifinals, which will define the two teams who will compete for the title.
From November 9 to 17, the Colombian city of Popayán hosted the second edition of the South American Youth Girls' Championship, where the Brazilian team was also crowned champion. The Brazilian team guided by the Argentine coach Daniel Moine are completing their preparations for the tournament at the High Performance Center in the Colombian capital.
Colombian coach Daniel Moine unveiled the expectations that he has for the team, "I think the championship is a great success for the South American Volleyball Confederation because it is a good opportunity for the kids to start gaining international experience, knowing what it is to be in a big tournament with the best teams in South America. Colombia have had good training time, which compensates for their lack of international exposure. The teams do not know each other well and I hope we have a good performance."
Qualification stage schedule (local tim)
December 4
December 5
December 6
Final stage schedule (local time)
December 7


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Rockledge, FL - Health First Health Plans (HFHP) today announced their rankings as one of the highest-rated Medicare health insurance plans in the nation. Health First Health Plans ranked number #20 among Medicare Advantage Plans in the National Committee for Quality Assurance (NCQA) Health Insurance Rankings - Medicare 2010-2011.
NCQA is an independent, not-for-profit organization dedicated to assessing and reporting the quality of managed care plans to help consumers, employers, and others make informed healthcare choices. NCQA's Health Insurance Plan Rankings have been widely recognized since 2005 as a valuable measure of clinical performance and customer satisfaction. More than 300 Medicare health plans across the nation were reviewed and evaluated with only 183 ranked based on customer satisfaction, prevention, and quality.
"This is an enormous achievement for our health plan," said Lisa Slattery, Director of Quality Management. "Health First Health Plans has a long-standing commitment to excellence in quality and service, and we continually strive to raise the bar so we can better serve our members."
For many Americans who will be choosing health plans during open enrollment season, the timing of this release could not be better. HFHP's commercial plans ranked #80 out of more than 300 plans that submitted data. NCQA ranked 237 participants in NCQA's Health Insurance Rankings -Private 2010-2011 category.
Only one other plan in Florida ranked higher for both commercial and Medicare products. All rankings are displayed online at www.ncqa.org.
"We are very proud of our employees, providers, and partners who do their best every day to provide a health plan of this caliber," Slattery said.


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Bond was reduced on Tuesday for Jonathan "Jay" Brooks, the co-founder of Compass Academy who was arrested last week and charged with securities fraud.
A bond reduction from $500,000 to $100,000 was approved for Brooks by Circuit Judge Thomas Cooper. A motion for bond reduction was made by Brooks' attorney Todd Rutherford.
Brooks, who shuffled into the courtroom wearing an orange jumpsuit, handcuffs and leg restraints, remained silent during the hearing except for a couple of whispered exchanges with Rutherford. He turned himself in to authorities on Friday and was charged with one count of securities fraud.
An arrest warrant alleges that Brooks took investment money for an entity called the "Charles Howell Trust," but the entity was fictional. Brooks instead converted the funds for his personal use, according to Assistant Deputy Attorney General Creighton Waters, who spoke for the Attorney General's office at Tuesday's proceeding.
Six of the alleged victims in the case were present in the courtroom on Tuesday.
"They are very concerned," Waters said.
"Obviously, their lives have been devastated by this crime and they are concerned that Mr. Brooks has access to funds and will flee from prosecution," Waters said.
Waters added that Brooks has cooperated with authorities. He recently moved his family to an unknown part of Texas.
"Given the gravity of the charges at issue and the fact that his family has moved to Texas … we believe that a surety bond is appropriate to ensure that Mr. Brooks returns to court," Waters said, requesting a bond of no less than $100,000.
Rutherford told the court that Brooks lived in Texas from 1998 to 2008, and that his family's move there was no secret.
"His move to Texas was not out of the blue and was not unknown to everybody," he said.
Rutherford mentioned that the finances of Brooks, his companies and Compass Academy are under the control of a court-appointed receiver, to whom Brooks has laid out "every dollar that he has." He added that because Brooks, who is 40 years old, has a wife and two children, turned himself into authorities and has since cooperated with the investigation, he should not be considered a flight risk, and requested a bond of less than $100,000.
"We believe a bond of $25,000 is certainly more appropriate … for someone in this situation," he said.
Cooper said the bond process is "sometimes the most misunderstood part of what we do."
"The fact that you have moved out of state will ratchet some of the concern that you may not return when you're supposed to," he said to Brooks.
The felony charge of securities fraud carries a possible punishment of up to 10 years in prison and/or a fine of up to $500,000.
Brooks, his wife and his companies have previously been accused by the state Attorney General's office of illegally selling unregistered securities to fund the establishment of a private school, Compass Academy, on Toolebeck Road. They have also been accused by the Securities Division of the Attorney General's office of using those funds to purchase groceries, their home, vacations and jewelry, rather than investing them.
Brooks also faces multiple civil lawsuits.
Teddy Kulmala covers the crime beat for the Aiken Standard and has been with the newspaper since August 2012. He is a native of Williston and majored in communication studies at Clemson University.