Rethinking the 150-Minute Physical Activity Threshold: From Categories to Evidence

Public health guidelines for adult aerobic physical activity over the past 2 decades have converged on a clear message: adults should aim for at least 150 minutes per week of moderate-intensity aerobic physical activity, or an equivalent combination of moderate and vigorous activity, to achieve substantial health benefits. This message is embedded in many national policies and surveillance systems, including the World Health Organization’s 2020 Guidelines and the Physical Activity Guidelines for Americans.1,2 It is important to note that current guidelines also recommend muscle-strengthening activities as a complementary component of overall physical activity guidance, although this commentary focuses specifically on aerobic physical activity recommendations.

However, as the evidence base grows particularly from large studies using device-measured physical activity, the conceptual foundation of this threshold warrants careful reconsideration. Evidence suggests that dose–response relationships between physical activity and key health outcomes are continuous and curvilinear rather than driven by discrete cut points; that beneficial effects accrue well below traditional thresholds; and that categorizing exposure may limit, rather than clarify, interpretation for individuals and policymakers.