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Title: CHRONICLE OF THE INSTITUTE OF MEDICINE PHYSICAL ACTIVITY RECOMMENDATION: HOW A PHYSICAL ACTIVITY RECOMMENDATION CAME TO BE AMONG DIETARY RECOMMENDATIONS

Author
item BROOKS, GEORGE - UNIV OF CALIFORNIA
item Butte, Nancy
item RAND, WILLIAM - UNIV OF CALIFORNIA
item FLATT, JEAN-PIERRE - UNIV OF CALIFORNIA
item CABALLERO, BENJAMIN - UNIV OF CALIFORNIA

Submitted to: The American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/19/2004
Publication Date: 5/10/2004
Citation: Brooks, G.A., Butte, N.F., Rand, W.M., Flatt, J., Caballero, B.H. 2004. Chronicle of the Institute of Medicine physical activity recommendation: how a physical activity recommendation came to be among dietary recommendations. American Journal of Clinical Nutrition. 79(5):921S-930S.

Interpretive Summary: An Institute of Medicine expert panel was appointed to make recommendations for daily energy or caloric intake that are compatible with good nutrition throughout the life span and that may decrease the risk of chronic disease. Recommendations for daily energy intake were based on rates of daily total energy expenditure (TEE) in healthy adults and children with normal body weights, as measured with the doubly labeled water method. Additional energy was recommended to support child growth and pregnancy and lactation. These rates of TEE were presented in units of physical activity level (PAL = TEE/BEE), where BEE is the basal rate of energy expenditure extrapolated to 24 h. It was found that most adults (66%) maintaining their weights in the healthful range had PAL values >1.6 which is equivalent to >=60 min of physical activity of moderate intensity each day. Based on the doubly labeled water data and the results of epidemiologic studies, the physical activity recommendation for adults was judged to be 60 min/d. The recommendation for children was for a minimum of 60 min/d. Dietary and physical activity recommendations for healthful living are inextricably intertwined. Adequate physical activity provides protection against chronic diseases and helps to balance energy expenditure and intake.

Technical Abstract: Under a contract from the US Department of Health and Human Services, a multidisciplinary expert panel was appointed to review "the scientific literature regarding macronutrients and energy and develop estimates of daily intake that are compatible with good nutrition throughout the life span and that may decrease the risk of chronic disease." Within the overall context of the charge, the panel sought to quantify rates and components of daily energy expenditure in healthy adults with body mass indexes (in kg/m(2)) of 18.5-25, in growing children (in the 5th-85th percentiles of weight-for-length), and in pregnant and lactating women. The recommendation for adults became the daily energy intake necessary to cover total daily energy expenditure (TEE). For special cases, dietary macronutrients and energy to support child growth and pregnancy and lactation by women were considered. TEE was based on the results of doubly labeled water studies, and the TEE results were presented in units of physical activity level (PAL = TEE/BEE) and DeltaPAL, where BEE is the basal rate of energy expenditure extrapolated to 24 h. Most adults (66%) maintaining a BMI in the healthful range had PAL values >1.6, or the equivalent of >=60 min of physical activity of moderate intensity each day. Hence, on the basis of the doubly labeled water data and the results of epidemiologic studies, the physical activity recommendation for adults was judged to be 60 min/d. The recommendation for children was for a minimum of 60 min/d. In conclusion, dietary and physical activity recommendations for healthful living are inextricably intertwined. Adequate physical activity provides protection against chronic diseases and helps to balance energy expenditure and intake.