Wood and Welsch (7) purport that the 59.9 kcal·d-1 mean difference we observed between days of continuous and intermittent walking was not meaningful because of unaccounted errors of measurement with the TRITRAC-R3D accelerometer. We agree that one should consider measurement errors when interpreting mean differences. We do not agree with their interpretation of our findings. Two empirical examples render moot the issue of measurement error in interpreting our findings. Using a sample similar to that studied by Fulton et al. (2), Mâsse et al. (5) estimated the inter-accelerometer agreement of the TRITRAC-R3D to be 0.99. We used this estimate to compute the standard error of measurement (SEM) as follows (1) : MATHwhere rxx’ = reliability of the accelerometer, 0.99, and ςx = standard deviation of the difference, 123.9 kcal·d-1 (not provided in the original paper). Using the SEM, we found that the true value of the observed mean difference lies between 35.6 and 84.2 kcal·d-1 with 95% confidence. Wood and Welsch (7) suggest using an estimate of accelerometer reliability of 0.95 from Nichols et al. (6). In doing so, the SEM was 27.7 kcal·d-1, and the true value lies between 5.6 and 115.2 kcal·d-1 with 95% confidence. Hence, either reliability estimate shows that the true value for the mean difference is not zero. Wood and Welsch suggest that the lower average daily MET value for the intermittent condition (4.05) relative to the continuous condition (4.13) accounts for our findings, estimating a difference of 2.6% (0.08 METs). We calculated a statistically nonsignificant difference (P = 0.57, p. 165) of 2.0% (0.08/4.05 = 1.98) as was noted also for the difference in duration (Fig. 2). We agree that activity intensity is an important aspect of energy expenditure to consider, as are frequency and duration, and we concede that “marginally lower” was generous to describe the smaller MET value. One must gain perspective to establish how meaningful is the difference we observed. Our study had ample statistical power to detect a 10% difference between the two walking conditions, amounting to 15 kcal·d-1 (e.g., 1.5 miles·100 kcal·mile-1·10%). Our finding was four times greater relative to this prescribed amount. However, prescribed and nonprescribed activity contributed to total daily energy expenditure (23% and 77%, respectively), revealing the need to compare the mean difference relative to the daily total. Wood and Welsch (7) calculate this difference to be 2.7% (presumably for the 2180 kcal·d-1 continuous walking condition). They question whether such a small percentage difference is meaningful even though we suggested it may thwart a weight gain of 4.5 pound·yr-1. Others have suggested that even smaller amounts of daily energy expenditure could also be very important (3,4,9). Thus, our findings have relevance for the worldwide obesity epidemic (8). Contrary to Wood and Welsch, we do not find that the difference of 59.9 kcal·d-1 between the intermittent and continuous conditions arises from either measurement error or differences in reported intensity. Whether the difference in estimated daily energy expenditure is reproducible and biologically important for public health must be resolved in future empirical investigations. Only time will tell. Janet E. Fulton, Ph.D. Louise C. Mâsse, Ph.D. Carl J. Caspersen, Ph.D., M.P.H.
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