This paper enlightens the background of the MET as well as rational body size-related scaling, and demonstrates how methodological confounding may affect physical activity assessment, which in turn may bias further analytical conclusions. For example scaling by body weight or METs has often been used when aiming to assess physical activity ( Strath et al., 2001, 2013 Brage et al., 2004, 2005 Corder et al., 2005 Crouter et al., 2008 US Department, 2008 Warren et al., 2010 World Health Organization, 2010). While physiologists are familiar with physiological relevance and potential problems of body size differences related scaling ( Tanner, 1949 Weir, 1949 Hoppeler and Weibel, 2005 Lorenzo and Babb, 2012 Tompuri et al., 2014a), there are physiological procedures which have been adapted to be used at the population level in health sciences. (2014), but from physiological point of view specific and truthful measurement is needed to assess physical activity related health interactions. Physical activity research consists also behavioral aspect, which has been taken into account in elaborate review by Hills et al. Physical activity is a major public health determinant ( Lim et al., 2012) and physical activity introduces public health promoting potential. This review discusses critically the metabolic equivalent of task (MET) ( Weir, 1949 Jetté et al., 1990), and its applicability to measure energy expenditure or to assess amount and intensity of physical activity. While physical activity as a behavior and cardiorespiratory fitness or adiposity as a state represents major determinants of public health, specific measurements of health determinants must be understood to enable a truthful evaluation of the interactions and their independent role as a health predictor. While standard METs are confounded by adiposity, lean mass proportional measures of energy expenditure would enable a more truthful choice to assess physical activity. This review demonstrates by examples that false methodology may cause paradoxical observations if physical activity would be assessed by body weight scaled values such as standard METs. However, the expression of energy expenditure by body weight to normalize the size differences between subjects causes analytical hazards: scaling by body weight does not have a physiological, mathematical, or physical rationale. The standard MET is defined as 3.5 ml/min/kg. Metabolic equivalents of task (MET) are multiplies of the resting metabolism reflecting metabolic rate during exercise. Hence the amount and the intensity of physical activity can be assessed by energy expenditure. Physical activity refers any bodily movements produced by skeletal muscles that expends energy. 2Institute of Biomedicine/Physiology, School of Medicine, University of Eastern Finland, Kuopio, Finland.1Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.
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