{
    "abstract": "A shift from self-reports to wearable sensors for global physical activity (PA) surveillance has been recommended. The conventional use of a generic cut-point to assess moderate-to-vigorous PA (MVPA) is problematic as these cut-points are often derived from non-representative samples under non-ecological laboratory conditions. This study aimed to develop age- and sex- (age-sex) specific cut-points for MVPA based on population-standardized values as a feasible approach to assess the adherence to PA guidelines and to investigate its associations with all-cause mortality.\nA total of 7601 participants (20-85+ years) were drawn from the 2003-2004 and 2005-2006 National Health and Nutrition Examination Surveys (NHANES). Minutes per week of MVPA were assessed with a hip-worn accelerometer. Counts per minute (CPM) were used to define an age-sex specific target intensity, representing the intensity each person should be able to reach based on their age and sex. Age-sex specific MVPA cut-points were defined as any activity above 40% of the target intensity. These population- and free-living-based age-sex specific cut-points overcome many of the limitations of the standard generic cut-point approach. For comparison, we also calculated MVPA with a generic cut-point of 1952 CPM. Both approaches were compared for assessing adherence to PA guidelines and association of MVPA with all-cause mortality (ascertained through December 2015).\nBoth approaches indicated that 37% of the sample met the 150+ min/week guideline. The generic cut-point approach showed a trend to inactivity with age, which was less pronounced using the age-sex specific cut-points. Overall mortality rates were comparable using generic cut-point (hazard ratio (HR)\u202f=\u202f0.61, 95% confidence interval (95%CI): 0.50\u20120.73) or age-sex specific cut-points (HR\u202f=\u202f0.57, 95%CI: 0.50\u20120.66) for the entire sample. The generic cut-point method revealed an age- and sex-related gap in the benefits of achieving 150+ min/week of MVPA, with older adults showing an 18% greater reduction in mortality rates than younger adults, and a larger difference in women than in men. This disparity disappeared when using age-sex specific cut-points.\nOur findings underscore the value of age-sex specific cut-points for global PA surveillance. MVPA defined with age-sex specific thresholds was associated with all-cause mortality and the dose\u2012response was similar for all ages and sexes. This aligns with the single recommendation of accumulating 150+ min/week MVPA for all adults, irrespective of age and sex. This study serves as a proof of concept to develop this methodology for PA surveillance over more advanced open-source acceleration metrics and other national and international cohorts.",
    "authors": [
        {
            "affiliation": "PROFITH \"PROmoting FITness and Health through physical activity\" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada 18071, Spain. Electronic address: jairo@jhmigueles.com.",
            "firstname": "Jairo H",
            "initials": "JH",
            "lastname": "Migueles"
        },
        {
            "affiliation": "PROFITH \"PROmoting FITness and Health through physical activity\" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada 18071, Spain; Institute for Innovation & Sustainable Development in Food Chain (IS-FOOD), Department of Health Sciences, Public University of Navarra, IdiSNA, Navarra Institute for Health Research, Pamplona 31006, Spain.",
            "firstname": "Cristina",
            "initials": "C",
            "lastname": "Cadenas-Sanchez"
        },
        {
            "affiliation": "Department of Biostatistics and Bioinformatics, The Biostatistics Center, Milken Institute School of Public Health, The George Washington University, Rockville, MD 20852, USA.",
            "firstname": "Nicole M",
            "initials": "NM",
            "lastname": "Butera"
        },
        {
            "affiliation": "Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, TN 37996, USA.",
            "firstname": "David R",
            "initials": "DR",
            "lastname": "Bassett"
        },
        {
            "affiliation": "Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD 20850, USA.",
            "firstname": "Dana L",
            "initials": "DL",
            "lastname": "Wolff-Hughes"
        },
        {
            "affiliation": "Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health and Johns Hopkins Center on Aging and Health, Baltimore, MD 21205, USA.",
            "firstname": "Jennifer A",
            "initials": "JA",
            "lastname": "Schrack"
        },
        {
            "affiliation": "Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20850, USA; Champalimaud Foundation, Lisbon 1400-038, Portugal.",
            "firstname": "Pedro F",
            "initials": "PF",
            "lastname": "Saint-Maurice"
        },
        {
            "affiliation": "Division of Cardiovascular Sciences, National Heart Lung Blood Institute, Bethesda, MD 20892, USA.",
            "firstname": "Eric J",
            "initials": "EJ",
            "lastname": "Shiroma"
        }
    ],
    "conclusions": "Our findings underscore the value of age-sex specific cut-points for global PA surveillance. MVPA defined with age-sex specific thresholds was associated with all-cause mortality and the dose\u2012response was similar for all ages and sexes. This aligns with the single recommendation of accumulating 150+ min/week MVPA for all adults, irrespective of age and sex. This study serves as a proof of concept to develop this methodology for PA surveillance over more advanced open-source acceleration metrics and other national and international cohorts.",
    "copyrights": "Copyright \u00a9 2025. Production and hosting by Elsevier B.V.",
    "doi": "10.1016/j.jshs.2024.100995\n10.1186/s12889-023-17281-4\n10.3390/s21103326\n10.1186/s12877-015-0093-1\n10.1093/gerona/glae113\n10.1186/s40798-019-0225-9\n10.1001/jamanetworkopen.2019.0355\n10.1371/journal.pone.0119591\n10.1136/bmj.l4570\n10.1371/journal.pone.0007038",
    "journal": "Journal of sport and health science",
    "keywords": [
        "Devices",
        "Exercise",
        "Mortality",
        "Movement sensors",
        "Physical activity"
    ],
    "methods": null,
    "publication_date": "2024-10-18",
    "pubmed_id": "39419307\n22818936\n33239350\n34006506\n24126387\n38242596\n38242592\n38242593\n37996871\n28303543\n33239352\n30548545\n21131873\n35253276\n9588623\n16294114\n34064790\n34385400\n31524826\n26238198\n38699999\n18091006\n20581716\n27510765\n31808014\n30418471\n32928741\n35247352\n30848809\n26853493\n25768112\n21685812\n31434697\n29733705\n22715120\n24578314\n19753111\n21917867\n27208067\n29191931",
    "results": "Both approaches indicated that 37% of the sample met the 150+ min/week guideline. The generic cut-point approach showed a trend to inactivity with age, which was less pronounced using the age-sex specific cut-points. Overall mortality rates were comparable using generic cut-point (hazard ratio (HR)\u202f=\u202f0.61, 95% confidence interval (95%CI): 0.50\u20120.73) or age-sex specific cut-points (HR\u202f=\u202f0.57, 95%CI: 0.50\u20120.66) for the entire sample. The generic cut-point method revealed an age- and sex-related gap in the benefits of achieving 150+ min/week of MVPA, with older adults showing an 18% greater reduction in mortality rates than younger adults, and a larger difference in women than in men. This disparity disappeared when using age-sex specific cut-points.",
    "title": "Development of an accelerometer age- and sex-specific approach based on population-standardized values for physical activity surveillance: A proof of concept.",
    "xml": "<Element 'PubmedArticle' at 0x788505005800>"
}