In Reply: We agree with Dr Bates and colleagues that the majority of US adults do not exercise at a level commensurate with optimal health benefits. Our study found that walking at least 1 h/wk is associated with a decreased risk of CHD. Because this level of activity is very modest, we believe it can serve as the impetus for totally sedentary women to begin exercising. However, as we stated in our article, this level of physical activity is less than the current recommended level of at least 30 min/d of moderate-intensity physical activity most days of the week.1 Therefore, we believe that our findings should be replicated. Meanwhile, we have emphasized that an appropriate interpretation of our findings would be to support current physical activity guidelines. We believe that there is a graded dose-response relation between physical activity and CHD risk: some activity is better than none, and more activity is better than a little. While our data do not strongly support a dose-response relation, as pointed out by Dr Lesser, this is probably because subjects were limited to those at the lower end of the spectrum for physical activity. The collective data on the association of physical activity with CHD risk—from our study as well as other studies of physically more active subjects—do support the notion of a dose-response relation.1
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