J Behav Med (2016) 39:624–632
DOI 10.1007/s10865-016-9740-z
Effects of moderate and vigorous physical activity on fitness
and body composition
Clemens Drenowatz1 • Vivek K. Prasad1 • Gregory A. Hand2 • Robin P. Shook3
Steven N. Blair1,4
Received: January 12, 2016 / Accepted: March 28, 2016 / Published online: April 7, 2016
Ó Springer Science+Business Media New York 2016
Abstract Current physical activity (PA) guidelines indi-
cate that moderate-intensity (MPA) and vigorous intensity
(VPA) PA provide similar benefits when total volume is
equal. The present study examined the associations of
MPA and VPA with body composition and cardiorespira-
tory fitness in free-living young adults. A total of 197
young adults (52.8 % male) were followed over a period of
15 months. Body composition was assessed via dual X-ray
absorptiometry and time spent in various PA intensities
was determined with a multi-sensor device every 3 months.
Cardiorespiratory fitness was assessed with a graded
exercise test at baseline and 15-months follow-up. Change
in VPA was positively associated with cardiorespiratory
fitness while MPA had beneficial associations with percent
body fat. In overweight/obese participants the association
with VO2peak was similar for MVPA bouts and VPA.
Even though MPA and VPA have positive associations
with overall health, their associations on key health
parameters differ.
Keywords Physical activity intensity
Body weight

Percent body fat
Exercise
Young adults
& Clemens Drenowatz
drenowat@mailbox.sc.edu
1
Department of Exercise Science, Public Health Research
Center, University of South Carolina, 921 Assembly Street,
Columbia, SC 29208, USA
2
School of Public Health, West Virginia University,
Morgantown, WV, USA
3
Department of Kinesiology, Iowa State University, Ames, IA,
USA
4
Department of Epidemiology and Biostatistics, University of
South Carolina, Columbia, SC, USA
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•
Introduction
The beneficial effects of physical activity (PA) on various
health outcomes, including body composition, cardiovas-
cular and metabolic disease risk as well as certain types of
cancer, are well established (Löllgen, 2013; O’Donovan
et al., 2010). In fact, physical inactivity has been identified as
the 4th leading risk factor for global mortality (World Health
Organization, 2010). In order to obtain substantial health
benefits a minimum of 150 min of moderate-intensity PA
(MPA) or 75 min of vigorous-intensity PA (VPA) or a
combination of MPA and VPA along with muscle
strengthening activities are recommended (Haskell et al.,
2007; U.S. Department of Health and Human Services,
2008). While it is further specified that higher PA levels
provide additional benefits, people are given a choice on how
to accumulate the recommended amounts of PA. MPA refers
to activities between 3 and 6 metabolic equivalents (METs),
such as walking or cycling at a speed \10 mph (Ainsworth
et al., 2011; Haskell et al., 2007). VPA refers to activities
above 6 METs, such as jogging or playing vigorous sports
(Haskell et al., 2007). The possibility to select between dif-
ferent PA intensities may facilitate compliance with current
recommendations but it poses the risk that people assume
MPA and VPA provide similar health benefits when the
overall dose is similar (i.e. MET-min/week). There remains,
however, limited information on the effects of different types
and intensities of PA on specific health outcomes (Physical
Activity Guidelines Advisory Committee, 2008).
Current evidence indicates greater beneficial effects of
aerobic exercise, compared to resistance exercise on visceral
adipose tissue, which is a major risk factor for metabolic
syndrome and cardiovascular disease (CVD) (Vissers et al.,
2013). The results were also attributed to differences in
exercise intensity as exercise of at least moderate intensity
J Behav Med (2016) 39:624–632
appears to be required in order to induce beneficial effects.
The importance of exercise intensity on various cardiovas-
cular disease (CVD) risk factors has also been indicated by a
recent meta-analysis of randomized controlled trials com-
paring exercise interventions of moderate and vigorous
intensity (Ramos et al., 2015). High-intensity interval
training was associated with a greater improvement in vas-
cular function compared to moderate-intensity continuous
training. In addition, there was a tendency towards larger
beneficial effects on inflammation, oxidative stress and
insulin sensitivity with high-intensity compared to moder-
ate-intensity training. Nevertheless, Ramos et al. (2015)
suggested a cautious interpretation of these results due to the
large variability in CVD risk factors and small sample size of
individual studies included in the meta-analysis.
Body composition and cardiorespiratory fitness are also
key health parameters that are affected by PA (Bastien
et al., 2014; Shah et al., 2016). Obesity is associated with
almost 70 % of cases of cardiovascular disease (World
Health Organisation, 2009). The role of cardiorespiratory
fitness in chronic disease risk may be even more pro-
nounced than that observed for excess body weight (Farrell
et al., 2002; Lee et al., 1999). An increase of 1 MET in
exercise capacity has been associated with an 8–17 % risk
reduction for cardiovascular and all-cause mortality (Swain
& Franklin, 2006). Clinical exercise studies have shown a
greater effect of higher exercise intensities on cardiores-
piratory fitness while the evidence on differential effects of
PA intensity on body weight or body composition has been
inconsistent when exercise interventions were matched for
energy expenditure (De Feo, 2013; Duscha et al., 2005;
Slentz et al., 2004; Swain & Franklin, 2006). It should,
however, be considered that many people may be reluctant
or not capable of engaging in VPA over a prolonged period
of time (Blair et al., 2004) and that an increase in VPA may
be associated with a reduction in MPA due to fatigue.
Observational studies that examine the association between
self-selected PA and key health parameters, therefore,
provide additional information on the role of lifestyle PA in
health promotion. The present study examines potential
differences in the associations of self-selected MPA and
VPA with cardiorespiratory fitness and body composition
in a free-living population. Further, associations of MPA
and VPA were analyzed separately for non-overweight and
overweight/obese adults due to potential differences in PA
engagement (Drenowatz et al., 2015; Hansen et al., 2013).
Methods
Baseline through 15-months data from a prospective
observational study on primary and secondary determinants
of weight change were used for the present analyses.
625
Details of the study protocol have been described previ-
ously (Hand et al., 2013). Participant recruitment occurred
via e-mail listservs, website postings, posters and flyers in
an urban area of South Carolina. Interested participants
were initially directed to an online screening platform to
determine eligibility. Participants needed to be between 20
and 35 years of age with a BMI between 20 and 35 kg/m2.
Further inclusion/exclusion criteria were freedom from
major chronic or acute health conditions and no consider-
able changes in health behaviors in the 3 months prior to
entering the study. Pregnant women or women who were
planning on getting pregnant as well as those planning to
change their use of contraceptive medications in the fol-
lowing 2 years were excluded. A total of 816 young adults
were deemed eligible based on the online screener. Upon
further review including baseline measurements 151 were
excluded due to medical conditions or an intention to
move, 66 declined to participate and 169 were lost
throughout the recruitment process; resulting in a sample
size of 430 (49 % male). The study protocol was approved
by the University of South Carolina Institutional Review
Board and is in accordance with the Declaration of Hel-
sinki. Informed consent was obtained from all individual
participants included in the study.
Anthropometric measurements were performed every
3 months by trained and certified staff. Height (cm) and
body weight (kg) was measured according to standard
procedures with participants in bare feet and surgical
scrubs using a wall-mounted stadiometer (Model S100,
Ayrton Corp., Prior Lake, MN, USA) and electronic scale
(HealthometerÒ model 500KL, McCook, IL, USA). The
average of two measurements of weight and height mea-
sured to the nearest 0.1 kg and cm, respectively was used
to calculate BMI (kg/m2) and classify participants as non-
overweight (BMI \ 25 kg/m2) or overweight/obese
(BMI C 25 kg/m2). Fat mass and lean mass were measured
via dual energy X-ray absorptiometry (GE Healthcare
Lunar model 8743, Waukesha, WI) and percent body fat
(%BF) was calculated (fat mass/body weight). Change in
fat mass and lean mass during the respective 3 months
periods along with average total daily energy expenditure
(TDEE) were used to estimate energy intake (Thomas
et al., 2012, 2010).
TDEE and PA were assessed every 3 months with the
SenseWear Mini Armband (BodyMedia Inc., Pittsburgh,
PA), which has been shown to provide accurate estimates
of energy expenditure and PA in healthy adults (Johannsen
et al., 2010; Welk et al., 2007). Participants were asked to
wear the armband continuously for a period of up to
14 days, except during activities when it might get wet.
Compliance was defined as at least 5 days (incl. 1 weekend
day) with a wear time of more than 18 h/day. During
periods of non-wear participants reported their activities in
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a log, which was subsequently matched to metabolic
equivalents (METs) based on the 2011 Compendium of
Physical Activities (Ainsworth et al., 2011); non-classified
activities were entered as 1.5 METs. Energy expenditure
during non-wear time was calculated using the individual’s
resting metabolic rate (RMR), which was measured via
indirect calorimetry (True One 2400, Parvo Medics, Sandy,
UT) after an overnight fast. SenseWear’s proprietary
algorithm (version 7.0 professional) was used to determine
the time spent in sedentary behaviors (\1.5 METs),
excluding sleep, time spent in light PA (1.5 to \3 METs),
time spent in MPA (3 to \6 METs), time spent in VPA
(C6 METs) and time spent in bouts of at least 10 min of
moderate-to-vigorous PA (MVPA bout; C3.0 METs).
A treadmill-based graded exercise test using a modified
Bruce Protocol was performed at baseline and 15-months
follow-up (Bruce, 1971). Cardiac activity was monitored
via a 12-lead EKG and oxygen consumption was measured
via indirect calorimetry (True One 2400, Parvo Medics,
Sandy, UT) throughout the exercise test. VO2peak was
determined as the highest value observed during the test
when at least two of the following criteria were met: res-
piratory quotient C1.15, rating of perceived exertion C17,
maximum achieved heart rate[90 % of age predicted heart
rate, plateau in heart rate and plateau in oxygen con-
sumption with increasing workload.
Statistical analysis
Descriptive statistics were calculated for the total sample
and separately for non-overweight and overweight/obese
participants. In order to be included in the analyses par-
ticipants needed to have valid PA data for at least 3 mea-
surement time points, including baseline and 15-months
follow-up measurements. Chi square and ANOVA were
used to examine baseline differences between participants
with valid data compared to those excluded from further
analyses. Differences between non-overweight and over-
weight/obese participants were examined via ANCOVA,
adjusting for sex and age. Individual change in measures of
adiposity and PA were determined via Linear Mixed Model
analyses, which allows for the inclusion of unbalanced
observations. Change in cardiorespiratory fitness was cal-
culated as the difference between VO2peak at baseline and
15-months follow-up. Cross-sectional associations between
time spent in different PA intensities and in body compo-
sition as well as VO2peak at baseline were examined via
Pearson correlations. Linear regression analyses were used
to determine the prospective association between time
spent at various PA intensities and measures of body
composition and cardiorespiratory fitness. Specifically, the
association of changes in VPA, MPA and MVPA bouts
with BMI, fat mass, lean mass, %BF and VO2peak at
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J Behav Med (2016) 39:624–632
15-months follow-up were examined. Model 1 included
sex, age, baseline values for the dependent variable as well
as baseline and change values for light PA, MPA and VPA
as independent variables. Model 2 was similar to model 1
except for the utilization of MVPA bouts and sedentary
time instead of MPA, VPA and light PA. Due to the
association between energy intake and body composition,
analyses were repeated including change in calculated
energy intake as additional covariate. All analyses were
performed with IBM SPSS Statistics for Windows (version
22.0; IBM Corp., Armonk, NY, USA) using a p value of
0.01 for statistical significance due to multiple compar-
isons.
Results
A total of 197 adults (52.8 % male) provided valid data.
Throughout the entire observation period participants wore
the SWA for 53.4 ± 4.5 days for an average of
23.2 ± 0.5 h/day. Almost 2/3 (64.5 %) of the participants
were Caucasian. There was no difference in baseline
characteristics (i.e. sex, age, ethnicity, education, anthro-
pometric measurements) between participants included in
the data analysis and those excluded due to non-compli-
ance. Of those included in the analyses, 75.6 % met current
PA guidelines of 150 min/week of MVPA in bouts of at
least 10 min, but only 20.8 % achieved more than 75 min/
week of VPA at baseline. Only 5.4 ± 5.5 % of total
MVPA was spent in VPA with no difference in the relative
contribution of VPA to total MVPA between non-over-
weight and overweight/obese participants.
Baseline characteristics for the total sample and sepa-
rately for non-overweight and overweight/obese partici-
pants are shown in Table 1. There was no difference in
race/ethnicity and sex distribution by weight category, but
non-overweight participants were younger than their
overweight/obese peers (p \ 0.01). Both fat mass and lean
mass were higher in overweight/obese, and they also had a
higher %BF compared to their non-overweight peers
(p \ 0.01). Time spent in light PA did not differ between
weight categories but non-overweight participants spent
less time in sedentary pursuits and more time in MPA,
VPA and MVPA bouts than overweight/obese participants
(p \ 0.01). VO2peak was higher in non-overweight par-
ticipants compared to overweight/obese (p \ 0.01).
Over the 15-months observation period the entire sam-
ple experienced a significant weight gain of 1.1 ± 4.3 kg
(p \ 0.01) (Table 2). The weight gain was due to an
increase of 0.8 ± 3.5 kg in fat mass and 0.3 ± 1.7 kg in
lean mass, resulting in a 0.6 ± 3.0 % increase in %BF
(p B 0.01). Individual weight change, however, ranged
from a weight loss of 8.3 kg to a weight gain of 8.9 kg.
J Behav Med (2016) 39:624–632 627

Table 1 Baseline characteristics of the total sample and separately for non-overweight and overweight/obese participants
Total sample (N = 197) Non-overweight (N = 108) Overweight/obese (N = 89)

Male (%) 52.8 50.0 56.2

College graduate (%) 86.8 88.0 85.4
White (%) 64.5 65.7 62.9
Age (years)* 27.8 ± 3.7 27.2 ± 3.5 28.5 ± 3.9
Height (cm) 172.2 ± 9.2 171.6 ± 9.5 172.7 ± 8.9
Weight (kg)* 75.4 ± 13.9 67.1 ± 9.5 85.6 ± 11.5
BMI (kg/m2)* 25.4 ± 3.8 22.7 ± 1.6 28.7 ± 2.9
Fat mass (kg)* 21.4 ± 8.6 16.8 ± 5.0 27.1 ± 8.9
Lean mass (kg)* 51.6 ± 10.6 48.2 ± 10.2 55.8 ± 9.6
% Body fat* 28.2 ± 8.9 25.5 ± 7.9 31.5 ± 8.9
Sedentary excl. sleep (min/day)* 691.2 ± 92.6 666.4 ± 89.3 721.5 ± 87.8
Light PA (min/day) 210.5 ± 58.0 205.5 ± 54.4 216.7 ± 61.8
MPA (min/day)* 124.7 ± 69.3 153.3 ± 71.0 89.6 ± 48.1
VPA (min/day)* 7.5 ± 8.5 9.3 ± 10.0 5.3 ± 5.5
MVPA bout (min/day)* 75.8 ± 59.7 101.3 ± 63.0 44.9 ± 36.8
VO2peak (ml/kg/min)* 38.5 ± 9.1 40.1 ± 8.9 36.5 ± 8.9
Values are prevalence (%) and Mean ± SD
PA physical activity, MPA moderate-intensity physical activity, VPA vigorous-intensity physical activity, MVPA bout moderate-to-vigorous
intensity physical activity accumulated in bouts of at least 10 min
* Significant difference between normal weight and overweight/obese participants (p \ 0.01)

Table 2 Change in body composition, physical activity and cardiorespiratory fitness from baseline to 15-months follow-up
Total sample (N = 197) Non-overweight (N = 108) Overweight/obese (N = 89)

D Weight (kg) 1.1 ± 4.3 1.5 ± 3.5 0.7 ± 5.0

D BMI (kg/m2) 0.3 ± 1.5 0.4 ± 1.2 0.1 ± 1.7
D Fat mass (kg) 0.8 ± 3.5 1.0 ± 2.7 0.6 ± 4.2
D Lean mass (kg) 0.3 ± 1.7 0.3 ± 1.5 0.2 ± 1.9
D % Body fat 0.6 ± 3.0 0.9 ± 2.7 0.3 ± 3.4
D Sedentary excl. sleep (min/day) 4.2 ± 66.2 13.1 ± 60.2 -6.6 ± 71.7
D Light PA (min/day) 2.0 ± 47.9 -3.1 ± 44.6 8.2 ± 51.3
D MPA (min/day) -2.6 ± 42.5 -5.1 ± 48.9 0.3 ± 33.0
D VPA (min/day) -0.4 ± 9.4 -0.6 ± 11.2 -0.3 ± 6.6
D MVPA bout (min/day) -1.9 ± 41.0 -2.9 ± 49.1 -0.7 ± 28.7
D VO2peak (ml/kg/min) -2.1 ± 5.1 -2.0 ± 5.3 -2.2 ± 5.0
Values are Mean ± SD
D Change from baseline to 15-months follow-up based on based on linear-mixed modelling, except for VO2peak, which was calculated as the
difference between baseline and 15-months follow-up

Change in fat mass and lean mass ranged from a loss of 6.2
and 2.7 kg to a gain of 7.1 and 3.6 kg, respectively.
Average VO2peak decreased by 0.12 ± 0.24 L/min
(2.1 ± 5.1 mL/kg/min) from baseline to 15-months fol-
low-up (p \ 0.01) with individual changes ranging from an
improvement of 0.30 L/min to a decline of 0.29 L/min
(-10.0 to +10.4 mL/kg/min). There was no significant
change in PA for the entire sample. Individual changes in
MPA and VPA ranged from a decline of 75 and
15 min/day to an increase of 75 and 15 min/day, respec-
tively. Change in body composition, VO2peak and PA over
the 15-month observation period did not differ between
non-overweight and overweight/obese participants.
At baseline, time spent sedentary, in MPA and VPA
were associated with body composition (except for lean
mass) and VO2peak (Table 3). The inverse association
between MPA and body composition, however, was more
pronounced compared to VPA. Results for MVPA bouts

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Table 3 Correlation coefficients between PA and body composition as well as VO2peak at baseline
BMI (kg/m2) Fat mass (kg) Lean mass (kg) % Body fat VO2peak (ml/kg/min)

Sedentary time (min/day) 0.385* 0.395* 0.044 0.321* -0.378*

Light PA (min/day) 0.081 0.091 -0.041 0.116 -0.053
MPA (min/day) -0.544* -0.625* 0.056 -0.588* 0.552*
VPA (min/day) -0.266* -0.346* 0.005 -0.316* 0.517*
MVPA bouts (min/day) -0.504* -0.561* 0.009 -0.516* 0.530*
Values are Pearson’s r
PA physical activity, MPA moderate physical activity, VPA vigorous physical activity, MVPA bout moderate-to-vigorous physical activity
accumulated in bouts of at least 10 min
* p \ 0.01

Table 4 Effect of change in PA on measures of body composition and VO2peak at 15 months, in the total sample and separately for normal
weight and overweight/obese
Dependent variable at 15-months follow-up D MPAa (min/day) D VPAa (min/day) D Sedentaryb (min/day) D MVPA boutb (min/day)
b p b p b p b p

Total sample
BMI (kg/m2) -0.050 0.077 -0.010 0.759 -0.007 0.801 -0.059 0.032
Fat mass (kg) -0.093 0.002 -0.023 0.522 0.005 0.872 -0.085 0.005
Lean mass (kg) 0.019 0.149 0.001 0.933 -0.009 0.502 0.012 0.360
% Body fat -0.101 \0.001 -0.015 0.628 0.010 0.703 -0.080 0.003
VO2peak (ml/kg/min) -0.005 0.910 0.210 \0.001 -0.027 0.543 0.035 0.408
Non-overweight
BMI (kg/m2) -0.122 0.088 0.045 0.623 -0.061 0.407 -0.142 0.058
Fat mass (kg) -0.125 0.027 -0.006 0.928 -0.050 0.397 -0.123 0.043
Lean mass (kg) 0.001 0.964 0.022 0.317 -0.018 0.320 -0.011 0.541
% Body fat -0.082 0.032 -0.016 0.746 -0.022 0.570 -0.067 0.102
VO2peak (ml/kg/min) -0.075 0.215 0.296 \0.001 0.038 0.568 0.022 0.737
Overweight/obese
BMI (kg/m2) -0.064 0.260 -0.102 0.085 -0.018 0.760 -0.123 0.022
Fat mass (kg) -0.135 0.007 -0.068 0.187 0.054 0.305 -0.139 0.004
Lean mass (kg) 0.064 0.008 -0.025 0.312 \0.001 0.993 0.050 0.033
% Body fat -0.150 \0.001 -0.026 0.517 0.053 0.216 -0.126 0.002
VO2peak (ml/kg/min) 0.103 0.068 0.132 0.026 -0.077 0.196 0.120 0.031
Values are standardized coefficients (b) and p value
D change in PA intensity determined via linear mixed model, MPA moderate-intensity physical activity, VPA vigorous-intensity physical
activity, MVPA bout moderate-to-vigorous intensity physical activity accumulated in bouts of at least 10 min
a,b
Separate regression models due to multicollinearity of independent variables
a
Adjusted for sex, age, baseline light PA, baseline MPA, baseline VPA, change in light PA, and baseline measures of the dependent variables
b
Adjusted for sex, age, and baseline sedentary time, baseline MVPA bout and measures of dependent variables

were similar to those shown for MPA. Results remained
essentially unchanged after controlling for sex and weight
category, except for the inverse association between VPA
and BMI, which was no longer significant. Results from the
regression analyses revealed a direct association of change
in VPA with VO2peak at follow-up, independent of MPA
(Table 4). MPA was independently associated with fat
mass and %BF at follow-up. Using MVPA bouts rather
than VPA and MPA separately resulted in similar results as
those shown for MPA, while sedentary time was not
associated with subsequent body composition or VO2peak.
Including change in energy intake in the regression model
did not change the previously reported results.
Even though change in time spent in different PA
intensities did not differ between normal weight and
overweight/obese participants, associations of change in

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PA intensity with cardiorespiratory fitness and body com-
position differed by weight category (Table 4). There were
no significant associations between change in PA and any
measure of body composition in normal weight partici-
pants, while the direct association of VPA on VO2peak
remained. In overweight/obese participants, MPA and
MVPA had significant associations with measures of body
fatness. Further, the association with VO2peak was similar
for MVPA bouts and VPA. As shown for the total sample,
results remained essentially unchanged when change in
energy intake was included in the regression model.
Discussion
The health benefits of regular PA have been well docu-
mented and clinical exercise trials have indicated differ-
ential effects of exercise intensity on various CVD risk
factors (Milanović et al., 2015; Ramos et al., 2015). There
remains, however, limited information on the specific
effects of self-selected MPA and VPA on key health
parameters, such as cardiorespiratory fitness and body
composition, in a natural setting. Results of the present
study indicate a direct association of VPA with cardiores-
piratory fitness while MPA had beneficial associations with
body composition. The associations of PA intensity, how-
ever, differed by weight status. Associations of MPA or
VPA with body composition were limited in normal weight
participants; VPA, however, was positively associated with
cardiorespiratory fitness. In overweight/obese participants,
bouts of MVPA as well as VPA were positively associated
with cardiorespiratory fitness and MPA and MVPA bouts
were associated with body composition.
The benefits of higher intensity PA for cardiorespiratory
fitness have been well documented in clinical studies,
suggesting that intensity is the major determinant of car-
diovascular adaptations in response to exercise (Duscha
et al., 2005; Kessler et al., 2012). As VPA can only be
sustained for a short period of time, high-intensity interval
training (HIIT) is commonly utilized in clinical exercise
interventions. Despite the shorter duration and lower
energy expenditure, HIIT has been shown to induce greater
improvements in cardiorespiratory fitness compared to
continuous MPA (Kessler et al., 2012; Milanović et al.,
2015). This may be due to increases in muscle mitochon-
drial biogenesis and GLUT-4 levels with high intensity PA,
which are less likely to occur in response to continuous
MPA (Little et al., 2010). In addition, high-intensity
exercise has been associated with increased work capacity
(Burgomaster et al., 2005), a healthier blood lipid profile
(Kemmler et al., 2014), higher insulin sensitivity (Ciolac
et al., 2010; Nybo et al., 2010), and better endothelial
function (Smith et al., 2003). Epidemiological studies also
629
showed a risk reduction for coronary heart disease and all-
cause cause mortality with higher PA intensities, inde-
pendent of activity volume (Laursen et al., 2012; Shiroma
et al., 2014). Accordingly, a meta-analysis concluded that
walking pace rather than time spent walking contributes to
longevity (Hamer & Chida, 2008). Taken together, these
results emphasize the importance of PA intensity on vari-
ous key health outcomes.
VPA, however, did not affect body composition, which
is also causally linked to cardiovascular disease risk (Hägg
et al., 2015). A recent meta-analysis also showed a more
pronounced effect of MPA on body composition compared
to VPA (Pattyn et al., 2014) and clinical exercise studies
showed a more pronounced reduction in body fat with
continuous moderate exercise compared to HIIT (Keating
et al., 2014; Nybo et al., 2010). The benefits of MPA on
body composition may be explained by the low amount of
VPA and the fact that caloric expenditure, rather than PA
intensity, is the primary determinant for changes in body
composition (Irving et al., 2008). As higher PA intensities
can only be sustained for a relatively short period of time,
volume and, therefore, energy expenditure is likely lower
compared to a prolonged engagement in MPA. Kemmler
et al. (2014), however, showed that moderate continuous
training resulted in larger weight loss than HIIT, even when
controlling for total work. A greater activation of fat
metabolism at lower PA intensities compared to a greater
reliance on carbohydrates at higher intensities may be one
explanation for this effect (Pattyn et al., 2014) as a
reduction or depletion in carbohydrate stores in response to
higher PA intensity has been suggested to stimulate dietary
intake in order to replenish carbohydrates. In fact, it has
been argued that the need to restore carbohydrates is
stronger than that to compensate for total calories burned
during the exercise (Pannacciulli et al., 2007; Snitker et al.,
1997). Accordingly, Pomerleau et al. (2004) showed a
more pronounced increase in appetite and food intake
following high-intensity exercise compared to moderate-
intensity exercise. An increase in energy intake in response
to higher PA intensities would minimize the energy gap
and subsequent change in body composition.
Results of the present study further indicate that weight
status affects the associations between PA intensity and
health-related parameters, which may be due to the ability
to engage in the respective PA intensities (Ohkawara et al.,
2007; Westerterp, 1999). The lack of significant effects of
VPA in overweight/obese participants could be explained
by difficulties in engaging in a sufficient amount of VPA.
Using average VO2peak values of the present sample, a
minimum relative intensity of 52 % of VO2peak would be
required to achieve intensities above 6 METs in non-
overweight participants, while the intensity would have to
be at least 58 % of VO2peak in overweight/obese partici-
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pants. The association between VO2peak and MVPA in
overweight/obese participants may be explained by the
lower initial fitness levels in this subgroup. At lower fitness
levels, bouts of MVPA may be sufficient to induce sig-
nificant changes in cardiorespiratory fitness, while higher
fitness levels necessitate higher intensities to further
increase cardiorespiratory fitness. Despite a significant
cross-sectional association between time spent sedentary
and body composition, there was no significant association
between change in sedentary time and subsequent body
composition. Even though sedentary time has been asso-
ciated with risk for type 2 diabetes, metabolic syndrome
and cardiovascular-disease (Duvivier et al., 2013; Proper
et al., 2011), results of the present study indicate that
reducing sedentary time does not provide any additional
benefits on body composition beyond those attributed to an
increase in PA. Different types of sedentary pursuits,
however, may affect health outcomes, including body
composition, differently. Chau et al. (2012) argue that
leisure-time sitting has a stronger association with body
weight than does occupational sitting. Further, TV time has
been associated with various measures of body fatness,
which was, at least partially, attributed to an increase in
energy intake while watching TV (Cleland et al., 2008;
Heinonen et al., 2013).
As the main emphasis of this study was on potential
differences in MPA and VPA, there was no further dif-
ferentiation between types of sedentary time. It should also
be considered that the study population consisted of pre-
dominantly white, well-educated participants with rela-
tively high activity levels (average physical activity level
of 1.8 ± 0.2), which limits the generalizability of the
results. Less active people with lower cardiorespiratory
fitness may experience beneficial changes in VO2peak with
less intense PA and potential beneficial changes in body
composition with light PA. In addition, the PA assessment
provided only information on total time spent at different
intensities and did not differentiate between structured
exercise and habitual PA. A previous study, however,
showed a low association between structured exercise and
MVPA in this population (Drenowatz et al., 2015). The use
of self-selected PA is also in line with current PA recom-
mendations, which emphasize the importance of lifestyle
PA in health promotion (U.S. Department of Health and
Human Services, 2008). Further, the utilization of objective
measures at multiple time points throughout the observa-
tion period is considered a major strength of the study.
Nevertheless, it is acknowledged that causation cannot be
established with observational studies; rather clinical trials
are needed to establish causal relationships between PA
and various health outcomes.
Overall, the present study provides valuable insights into
the differential effects of MPA and VPA on cardiorespiratory
123
J Behav Med (2016) 39:624–632
fitness and body composition in a young free-living popu-
lation. Given the importance of PA in a healthy lifestyle,
current guidelines provide several options to meet the min-
imum PA recommendations. While this may help to reach a
larger number of people, these guidelines could be inter-
preted in a way that effects of different PA intensities are
similar when the total volume is constant. There is, however,
emerging evidence, including the present study, which
suggests that MPA has a stronger effect on body composi-
tion, while higher intensities are beneficial for increasing
cardiorespiratory fitness (Gebel et al., 2015; Pattyn et al.,
2014). While any PA is better than none (Haskell et al., 2007)
and both MPA and VPA provide valuable health benefits,
differential effects of various PA intensities should be
communicated clearly in order to avoid unreasonable
expectations, which could result in people stopping their
engagement in regular PA due to lack of perceived success.
Acknowledgments The authors wish to thank the advisory board,
staff, and participants of the Energy Balance Study. The study was
funded by a research grant from the Coca Cola Company. The funder
had no role in any aspect of the study design, data collection, or data
analysis.
Compliance with ethical standards
Conflict of interest Clemens Drenowatz has received funding from
the Coca Cola Company. Gregory A. Hand has received funding from
the NIH, Health Resources and Services Administration, American
Heart Association, The Coca Cola Company, and TechnoGym. Robin
P. Shook has received travel grants from The Coca Cola Company.
Steven N. Blair receives book royalties (\$5000/y) from Human
Kinetics and honoraria for lectures and consultations from scientific
educational and lay groups. He has received research grants from the
NIH, Department of Defense, Body Media, and The Coca Cola
Company. Vivek K. Prasad declares that he does not have any conflict
of interest.
Human and animal rights and Informed consent All procedures
performed in studies involving human participants were in accor-
dance with the ethical standards of the institutional and/or national
research committee and with the 1964 Helsinki declaration and its
later amendments or comparable ethical standards. Informed consent
was obtained from all patients for being included in the study.
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