Getting to the MET of the matter: New chart helps women measure fitness level

Women now have their own chart of MET levels to determine exactly how fit they are, or ought to be, for their particular age.
Danielle Tripp and Megan Weatherly of Kansas City, both 22, are avid exercise buddies. They hit the gym up to five times a week. They lift weights, cycle and estimate their fitness levels from feel, calories, distances and times.

But do they ever check their "MET" levels?

"I never even pay attention to it," Tripp said.

Now it's time.

What are metabolic equivalents?

MET stands for metabolic equivalents. Displayed on most exercise bikes, elliptical trainers and other exercise machines, it's a rough measure of oxygen consumption and thus the metabolism rate for any given activity.

Based on new research published in today's The New England Journal of Medicine, women can now use their own chart of MET levels to determine exactly how fit they are, or ought to be, for their particular age.

The chart, or so-called nomogram, was put together by cardiologist Martha Gulati and a team of researchers at Chicago's Rush University Medical Center. It's based on 10 years' worth of studies of some 6,000 women, beginning in 1992.

Gulati, now at Northwestern University, said cardiologists for years have used MET levels as part of cardiac treadmill tests.

In general, the higher the MET level one can reach -- on a scale from 1 to 15 -- the more fit the person is. She said how long the person can maintain the MET level isn't important: The person should simply be able to reach the level.

More than just a fitness guide

Until today's report, women did not have their own MET chart. All MET standards were based on research on men, thus setting the fitness levels for women artificially high and more difficult to meet.

"Women are never going to be small men; they're women," Gulati said. "Because we're finally studying women, we're finally getting data that applies to women and works for women."

But more than just being a fitness guide, the research has an alarming side. The study is based on 5,721 women between the ages of 35 and 93 whose health ranged from good to risky. The work showed that, with in the study, women whose exercise capacity was less than 85 percent of what it should be were twice as likely as their healthier peers to die within eight years.

"It's supposed to tell you how fit you are for your age," Gulati said. "Hopefully, this will help change the way women's fitness and health is measured."

Now that this new chart is available, Gulati said she hopes that women will use it not only to monitor their fitness but also to insist on MET measurements as part of annual physical exams. She hopes physicians will begin talking more about METs.

"We draw blood. We take mammograms. We ask about cholesterol, but how often do we measure fitness level?" Gulati said. "I think every exam should include a fitness prescription."

A method to encourage more exercise

Gerald Fletcher, a cardiologist at the Mayo Clinic in Jacksonville, Fla., and a spokesman for the American Heart Association, said the guidelines for women will help physicians encourage patients with poor fitness levels to get more exercise to reach their expected MET level.

"Overall, I think this is a very good guideline to be done carefully in people who are not at high risk," he said.

With MET levels, measuring is relatively easy. One can think of METs as the amount of effort it takes a person to perform an activity. Standing still equals about one MET. The more vigorous the activity, the higher the MET.

Casually walking equals three to six METs. Jogging can run it up to more than 10.

Of course, optimal fitness depends on age. According to the new chart, a 65-year-old woman who reaches a little more than six METs is 100 percent fit. If she reaches only about three METs, she is 50 percent fit. But a woman who is 35 needs to reach 10.15 METs to be considered 100 percent fit. A 40-year-old woman needs to reach 9.5.

Will it be used?

Exactly who will use the new chart and how is anybody's guess. At the Kirmayer Fitness Center, which is part of the University of Kansas Hospital, Tripp and Weatherly said that any number that helps them determine fitness is useful. Now that the chart is out, they said, the number displayed on their exercise machines has greater meaning.

"If it's an accurate indicator of how fit you are, it's beneficial," said Heidi Seuling, 31, who was working out on an elliptical trainer nearby. Seuling, who has run two marathons, said she exercises about four times each week.

"It's good," she said, "that there's another way to measure fitness other than how you feel. You can actually get a number."

But Linda Banks, 36, said that for her, the fitness world is full of enough numbers, from calories to body-mass index, and now METs.

"I don't want to depend on that," she said.

Over the past few years, Banks has lost more than 100 pounds. She did it through diet, exercise, support from friends and spirituality.

"That was my support," she said. The best exercise number she has, she said, is the phone number of a friend, 30 years her senior, who has always encouraged her.

Konnie Sanders, 55, working out at Woodside Health Club, is of a similar mind. Although numbers may help, she said, the key for her is working out regularly, paying attention to what she eats and listening to her body. The numbers on her exercise cycle tell her she can peddle for 60 minutes with a heart rate of 150.

"How are you really going to know it's accurate?" Sanders asked of the MET levels.

Gulati's take: "First of all, the average person isn't exercising," she said. "The first message is 'Exercise is important. The degree of fitness is important.' We should not be minimizing it."

The second message: "How much activity should you be doing? That hasn't changed," she said. "Thirty minutes, moderately intense, every day."

Learning about METs

Three women who work out at the Sylvester Powell Jr. Center, 6200 Martway in Mission, Kan.:

Shenya Vanoy, 18

  • How do you know when you're fit?
    When I don't get tired when I'm exercising or worn out when I'm done.

  • Ever heard of METs?
    I've never heard of it.

  • Now that you've heard of it, will you use it?
    Yes. I'd use anything that gives me a better idea of where I'm standing.
  • Lisa Wright, 50

  • How do you know when you're fit?
    I know I'm fit when I wake up in the morning with plenty of energy and still have energy in the evening, and when I'm sleeping better.

  • Ever heard of METs?
    No. I do know about metabolism.

  • Now that you've heard of it, will you use it?
    Definitely. People want to know that.

  • Virginia Grindel, 71

  • How do you know when you're fit?
    I live in a very hilly subdivision. I know I'm fit when I can walk up and down the hills and I don't have to stop in the center.

  • Ever heard of METs?
    I've never heard of that.

  • Now that you've heard of it, will you use it?
    I'm not sure I care about it. Maybe if it were 20 years ago, I'd be a lot more interested. I think now it's a lot more important to just try to stay active.

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