Promoting public health through the 2024 Compendium of Physical Activities: Strategies for adults, older adults, and wheelchair users

Physical activity (PA) is fundamentally linked to public health,¹ providing benefits including chronic disease prevention and treatment,² mental health,³ musculoskeletal health,⁴ and healthy aging,⁵ along with socioeconomic advantages.⁶ These benefits highlight the importance of promoting PA for all populations. The recent publication of the Compendium of Physical Activities (Compendium) serves as a valuable resource,⁷ offering an updated and expanded guide for adults (ages 19–59) with tailored energy cost values for diverse populations, including older adult (OA) ages 60 and older⁸ and wheelchair (WC) users.⁹ This paper provides a commentary on the 2024 edition of the Compendium, following updates published in 1993, 2000, and 2011,¹⁰ highlighting its integration of recent research that can be used to bridge the gap between research and practice, supporting effective public health strategies to increase PA.

1. Standardized measurement of PA

The 2024 Compendium update involved an extensive systematic review of the literature to identify new activities and measured energy cost values, enhancing its accuracy and comprehensiveness. This updated version, along with the 2018 Youth Compendium,¹¹ provides standardized codes and metabolic equivalent (MET) values for a wide range of PAs across the lifespan, including WC users. METs reflect the intensity of PA as multiples of the resting metabolic rate (1.0 MET) classified as sedentary behaviors (1.0–1.5 METs), light-intensity PA (1.6–2.9 METs), moderate-intensity PA (3.0–5.9 METs), and vigorous-intensity PA (≥6.0 METs). A 5- to 7-digit numeric activity code in each Compendium identifies the Major Heading (e.g., Home Activities, Sports, Walking, and other activities), a Specific Activity in each Major Heading (e.g., walking at 2.5 miles per hour on a level grade, sitting and using a computer at work, or playing a basketball game), and the associated MET energy cost value. The coding system allows consistent tracking and recording of PAs, facilitating comparisons across different studies and populations, and benchmarking progress in PA initiatives.

While the Adult Compendium uses multiples of a standard MET, defined as a resting metabolic rate of 3.5 mL/kg/min or 1.0 kcal/kg/h, the other Compendiums use population-specific values that adjust for resting metabolic rate unique to those groups (OAs: MET₆₀₊ = 2.7 mL/kg/min or 0.810 kcal/kg/h; WC users: MET_WC = 1.0 mL/kg/min or 0.992 kcal/kg/h) and age groups for youth (MET_y age groups: 6–9 years, 10–12 years, 13–15 years, and 16–18 years). This approach ensures that sedentary behaviors and PAs are relevant to each population and allows for tailored recommendations.

2. Bridging the gap: The Compendium's role in connecting research to practice

2.1. Guideline development and policy making

Public health guidelines for PA and sedentary behaviors, such as those issued by the World Health Organization¹² and the European Union,¹³ often use data from the Compendium to recommend specific types, intensities, and amounts of activity for health benefits. For example, the World Health Organization guidelines on PA and sedentary behavior recommend that adults engage in moderate-intensity PA for 150–300 min/week, or vigorous-intensity PA for 75–150 min/week, or an equivalent combination of the 2 intensities.¹² This information supports the public health workforce in developing public health policies and communicating health benefits clearly and effectively, tailored to the needs of their populations.¹⁴ This might include engaging urban planners in decision-making that encourages active transport, working with recreation departments in the development of public parks and sports facilities,¹⁵ and encouraging educators to integrate PA into the school curriculum.

2.2. Tailored health communications and community health initiatives

Knowing the intensities of various sedentary behaviors and PAs provided in the Compendium allows for tailored recommendations in public health messages and campaigns. By understanding the MET values associated with different PAs, health advocates can provide clear, personalized, and realistic advice that aligns with an individual's interests and capabilities. This alignment can foster greater public engagement and adherence to recommended PAs.

Moreover, using the Compendium in planning community health initiatives encourages community engagement and collaboration among local health departments, schools, and other community stakeholders. This collaborative planning can facilitate the integration of PAs with appropriate intensities into the community's daily life, which can also be culturally tailored leading to more comprehensive and sustainable health initiatives.¹⁶

2.3. Inclusive PA promotion

Promoting PA inclusively involves ensuring that people of all abilities and ages can access relevant information and options. By providing MET values for a wide range of PAs, including those suitable for people with mobility disabilities, children, and OAs, the Compendium supports inclusive PA health promotion efforts to engage every population segment. Experiencing barriers to PA, such as recommending PA types or PAs with intensities exceeding a person's abilities, can make it difficult for individuals to adopt new and sustainable PA behaviors. Promoting the energy cost of non-traditional and population-specific PAs obtained in the Compendium may more effectively connect with individuals who have been excluded or felt ignored from past PA opportunities.

2.4. Health promotion program planning

Health promotion programs can use the Compendium to choose activities that meet specific intensity levels appropriate for various demographics, such as children, OAs, or those with mobility challenges. This precision in planning helps to craft PA interventions that are safe and effective in promoting health according to the capabilities and limitations of the participants. For instance, in creating PA programs for OAs, health advocates might select activities with lower MET values that still contribute to cardiovascular health while reducing the risk of adverse events. Additionally, using the Compendiums’ standardized Specific Activity codes to track PAs performed can help to evaluate PA intervention programs’ effectiveness by providing a way to measure changes in PA levels over time.¹⁷ Thus, understanding specific PAs and PA intensities can help programs to tailor interventions to meet specific needs or target specific areas for improvement, which can be used to measure the change over time.

The Compendium has been used as a tool in fitness technology, providing the general public with a comprehensive guide to various PAs and their energy cost values. Integrated into fitness apps and wearable devices, such as fitness trackers and smartwatches, the Compendium enables users to track their PAs and PA behaviors, which the devices alone may not capture. By allowing individuals to monitor and quantify their daily movements, the Compendium empowers users to set and achieve their fitness goals more effectively. Whether counting steps, monitoring calorie burn, or recommending specific activities, integrating the Compendium into fitness technology enhances the user experience, promoting a healthier and more active lifestyle.

2.5. Fitness professionals

The Compendium is also a resource for fitness professionals to inform clients about the variety and intensity of PAs performed. This knowledge is crucial for designing effective, personalized exercise prescriptions for clients and for advising about appropriate health-enhancing PAs. Fundamental components of an exercise prescription are the intensity, duration, and frequency of any given type of activity.¹⁸ The Compendium provides specific MET intensity values for many different types of exercise, including conditioning, sports, leisure, and dance activities. Knowing the intensity of various PAs allows fitness professionals to empower clients to incorporate PAs beyond those in a typical fitness facility. Further, understanding MET values helps fitness professionals to adapt and prescribe precise exercise intensities that are safe and effective for different populations, including for those with chronic conditions or disabilities.

3. Practical application of the Compendium during the Paris 2024 Olympic Games

In conjunction with the Paris 2024 Summer Olympic Games, France, providing a global stage to promote PA, we highlight a PA example using historical landmarks in the host city. Before he was elected the third President of the United States of America in 1801, Thomas Jefferson served as the Minister of France from 1784 to 1789. During this time, Thomas Jefferson lived in an apartment at the Hotel de Langeac on the Champs-Elysees. He frequently used his conte pas (step counter) to document the distance between his residence and different landmarks in Paris.¹⁹ Following some of the same routes that Jefferson walked, Table 1 depicts the energy cost of each route for an 80 kg person using each of the Adult, WC, and OA Compendium.

Table 1.

Energy cost of walking to destinations in Paris using data from the Adult, Wheelchair, and Older Adult Compendiums of Physical Activities.

1787 Paris	2024 Paris	Distance (km)	Length of activity (min)	Energy cost (kcal)a
				Adult walking 3.2–3.9 km/h 2.8 MET	Wheelchair wheeling on sidewalk 3.2 METWC	Older Adult walking 3.2 km/h 3.8 MET60+
Grille de Chaillot to Grille de Neuilly	92 Av. des Champs-Élysées to Neuilly-Porte maillot Metro Stop	1.6	30.0	112.0	127.0	123.1
Grille de Chaillot to Roule	92 Av. des Champs-Élysées to Fnac (electronics store) 26 Av. Des Ternes	1.2	22.5	84.0	95.2	92.3
Grille de Chaillot to Statue Louis XV	92 Av. des Champs-Élysées to Place de la Concorde	1.6	30.0	112.0	127.0	123.1
Statue Louis XV to Chateau des Tuileries	Place de la Concorde to Av. Du Général Lemonnier	0.8	15.0	56.0	63.5	61.6
Grille de Chaillot to Chateau des Tuileries	92 Av. des Champs-Élysées to Av. Du Général Lemonnier	2.7	50.6	188.9	214.2	207.7

Notes: Specific Activity codes: Adult = 17152 (walking, 2.0–2.4 mph, level, slow pace, and firm surface); Wheelchair = 90630 (wheeling on sidewalk); Older Adult = 1715360 (walking, 2.0 mph, level, slow pace, and firm surface).

^aWhen the body weight is 80 kg, adult MET to kcal = MET × 80 kg × length of activity (min)/60; MET_WC to kcal = MET_WC × 0.992 kcal/kg/h × 80 kg × length of activity (min)/60; MET₆₀₊ to kcal = MET₆₀₊ × 0.810 kcal/kg/h × 80 kg × length of activity (min)/60. A downloadable Excel file for Compendium calorie conversions is available at https://pacompendium.com/compendium-calculator/.

Abbreviations: MET = metabolic equivalent; MET₆₀₊ = metabolic equivalent of ages 60 and older; MET_WC = metabolic equivalent of wheelchair users; mph = mile per hour.

4. Summary

The Compendium of Physical Activities serves as a valuable tool for public health professionals, policymakers, community leaders, educators, and fitness professionals seeking to increase PA levels within populations. Knowing population- and age-specific PA MET values offers new opportunities for inclusive and tailored PA health promotion to reach and engage more individuals in health-enhancing PAs.