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Thompson, Dylan; Peacock, Oliver; Western, Max; Batterham, Alan M.

Exercise and Sport Sciences Reviews: October 2015 - Volume 43 - Issue 4 - p 239
doi: 10.1249/JES.0000000000000060
Letters to the Editor in Chief

Department for Health, University of Bath, Bath, UK

Health and Social Care Institute, Teesside University, Middlesbrough, UK

Dear Editor in Chief:

We agree with Mr. Machado de Rezende and Dr. Rey López that the environment is of course important, policy certainly has a major role to play, and creating local opportunities for physical activity is naturally part of a multicomponent public health strategy. The core tenets of our review (4) entirely are consistent with this perspective, and the only point of difference seems to be that we are open to the idea that there are other ways to intervene successfully.

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If exercise is medicine, then individuals need unambiguous feedback about the required “dose.” Even with changes to our environment, we cannot assume that people will capitalize on new opportunities and certainly they will continue to struggle to judge correctly whether their behavior is appropriate. Self-monitoring and feedback on performance are demonstrably effective strategies to address this information gap (e.g., (2)). Technology is not a determinant of physical activity, and we never said that it was. Technology is a tool to facilitate understanding, provide feedback and information, and enable specific goal setting (2,4). For example, we recently demonstrated how technology-enabled feedback clarifies misconceptions about physical activity and is revealing and educational (7). One of the things that people find most surprising is how much of their physical activity is accumulated in unexpected contexts and settings. Thus, with or without changes to the environment, individuals will benefit from the insight provided by technological innovation. We argue that informational feedback needs to be multidimensional to account for the different ways in which physical activity can impact health (3).

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Sadly, individuals have little direct control over large parts of their environment. There is not much that they (as individuals) can do about the availability of cycle lanes and local parks (etc.). Until we live in a physical activity–enabled utopia, people will have to seek out opportunities to engage in healthful physical activity. Technology can be used to illustrate many of these opportunities. For example, even a sedentary person expends hundreds of kilocalories a day through some form of physical activity (1,6). Technology can be used to illustrate where and when this physical activity has taken place. As noted previously, this often is in surprising contexts and environments. Such information can be used to break down barriers and arm people with personalized and feasible physical activity opportunities that are relevant to them. Furthermore, technology can be used to demonstrate and model the potential impact of new behaviors so that individuals understand the consequence of changing behavior (e.g., tackling multidimensional issues such as compensation and substitution to avoid naive and/or erroneous conclusions (4,5)). Although the environment undoubtedly is important, people may find this technology-enabled approach easier than lobbying the local authorities to build a new cycle lane or park.

Thankfully, we do not have to place all our eggs into one basket when it comes to physical activity for health.

Dylan Thompson

Oliver Peacock

Max Western

Department for Health

University of Bath

Bath, UK

Alan M. Batterham

Health and Social Care Institute

Teesside University

Middlesbrough, UK

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1. Brooks GA, Butte NF, Rand WM, Flatt JP, Caballero B. Chronicle of the Institute of Medicine physical activity recommendation: how a physical activity recommendation came to be among dietary recommendations. Am. J. Clin. Nutr. 2004; 79(5): 921–30.
2. Michie S, Abraham C, Whittington C, McAteer J, Gupta S. Effective techniques in healthy eating and physical activity interventions: a meta-regression. Health. Psychol. 2009; 28(6): 690–701.
3. Thompson D, Batterham AM. Towards integrated physical activity profiling. PLoS ONE. 2013; 8(2): e56427.
4. Thompson D, Peacock O, Western M, Batterham AM. Multidimensional physical activity: an opportunity, not a problem. Exerc. Sport. Sci. Rev. 2015; 43(2): 67–74.
5. Thompson D, Peacock OJ, Betts JA. Substitution and compensation erode the energy deficit from exercise interventions. Med. Sci. Sports Exerc. 2014; 46(2): 423.
6. Turner JE, Markovitch D, Betts JA, Thompson D. Nonprescribed physical activity energy expenditure is maintained with structured exercise and implicates a compensatory increase in energy intake. Am. J. Clin. Nutr. 2010; 92(5): 1009–16.
7. Western MJ, Peacock OJ, Stathi A, Thompson D. The understanding and interpretation of innovative technology-enabled multidimensional physical activity feedback in patients at risk of future chronic disease. PLoS ONE. 2015; 10(5): e0126156.
© 2015 American College of Sports Medicine