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Potential impact of wearables on physical activity guidelines and interventions: opportunities and challenges
  1. Jason MR Gill1,
  2. Timothy J Chico2,
  3. Aiden Doherty3,
  4. Jessilyn Dunn4,
  5. Ulf Ekelund5,6,
  6. Peter T Katzmarzyk7,
  7. Karen Milton8,
  8. Marie H Murphy9,
  9. Emmanuel Stamatakis10
  1. 1 British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
  2. 2 Infection, Immunity, and Cardiovasccular Disease, University of Sheffield, Sheffield, UK
  3. 3 Nuffield Department of Population Health, Oxford University, Oxford, UK
  4. 4 Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA
  5. 5 Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
  6. 6 Department of Chronic Diseases and Ageing, The Norwegian Institute for Public Health, Oslo, Norway
  7. 7 Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
  8. 8 Norwich Medical School, University of East Anglia Faculty of Medicine and Health Sciences, Norwich, UK
  9. 9 Institute for Sport Physical Education and Health Sciences, University of Edinburgh, Edinburgh, UK
  10. 10 School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Professor Jason MR Gill, British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK; Jason.Gill{at}

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Hundreds of millions of people own wearable devices capable of tracking their movement patterns.1 Accelerometers are also increasingly the preferred tool to measure physical activity in research studies.2 However, national and international physical activity guidelines, which recommend adults undertake at least 150–300 min of moderate intensity physical activity (MPA) or 75–150 min of vigorous intensity physical activity (VPA) per week, remain largely based on epidemiological studies in which physical activity was assessed using self-reported questionnaires. It is now known that such self-report measures generally overestimate moderate-to-vigorous physical activity (MVPA), are unlikely to accurately measure light intensity physical activity, and cannot capture very short bouts of incidental activity of any intensity.3 These limitations impede the development of guidelines that reflect the true dose–response relationship between physical activity and health.

Recent prospective studies using wearable devices have started to transform our understanding of the association between physical activity and health outcomes. These suggest that the dose–response relationship between physical activity and health is steeper than self-report data suggest, with substantially smaller doses of device-measured MVPA (~40–80 min/week) associated with benefits similar to those from achieving the currently recommended levels (based on self-report), and an even greater benefit of being highly active than previously appreciated from self-reported data.4 5 Such data have also demonstrated that just 3–4 min/day of device-measured intermittent VPA is associated with 30%–40% lower risk …

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  • Contributors This work was originally conceived by JMRG, TJC and ES, and all authors made substantial contributions to refining and shaping the initial ideas. JMRG wrote the first draft; all authors contributed to revisions in subsequent drafts. All authors approved the final version and are accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests JMRG is deputy editor for Physical Activity and Population Health at BJSM. AD is supported by the Wellcome Trust (223100/Z/21/Z), Novo Nordisk, Swiss Re, the British Heart Foundation Centre of Research Excellence (grant number RE/18/3/34214). ES is funded by an Australian National Health and Medical Research Council (NHMRC) Leadership level 2 Investigator Grant (APP 1194510).

  • Provenance and peer review Commissioned; externally peer reviewed.

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