Beyond FITT: addressing density in understanding the dose-response relationships of physical activity with health-an example based on brain health.

Research on physical activity (PA) and health has a fundamental concern with dose-response relationships. The variables of (1) Frequency, (2) Intensity, (3) Time, and (4) Type (i.e., the FITT principle) have traditionally been used to operationalize the dosage of PA. We consider some limitations of FITT and propose that it can be complemented by the additional variable density (from the German exercise and training variable Belastungsdichte), which can be defined as the timing of successive work bouts within a single PA bout as well as the timing between successive PA bouts within a specific time period; it does so by quantifying the temporal intervals between successive work or PA bouts (i.e., time spent at a lower PA intensity or resting such as in napping/sleeping or sedentary behaviors). Using the field of PA and brain health as an example, we discuss the opportunities and challenges for further research employing the variable density and consider its potential to improve the understanding of dose-response relationships between PA and health outcomes.