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The evidence base

Every threshold, traced to its source.

28 citations across 8 topics. No proprietary score you can't check the math on — every number below is the same one used inside the app, and every number links to where it came from.

See the whole AHA statement as one map226 concepts on cardiorespiratory fitness — interactive, pan and zoom.

METs vs MET-h

Methodology — not a citation, this is how Verve computes it

Video walkthrough — METs vs MET-h

In production, coming soon

METs — how hard

A Metabolic Equivalent of Task (MET) is the energy your body uses per kg of body weight per minute, relative to rest. 1 MET = sitting quietly, using 3.5 mL of O₂/kg/min. Every activity — walking, running, lifting — gets a METs value showing how many times harder it is than sitting still.

< 3.0 METsLight
3.0 – 5.99 METsModerate
≥ 6.0 METsVigorous

MET-h — how much

MET-hours (MET-h) multiply intensity by time:METs × hours. It's the session's training volume, not its intensity. 1 MET-h ≈ 1 kcal burned per kg of body weight (the energy cost of one hour at rest, scaled by your weight) — so MET-h isn't the same number for everyone at the same intensity.

Worked example

A 36-minute strength session averaging 3.4 METsis classified moderate intensity (it's the METs value that sets the label). Its volume is 3.4 × 0.6 hours (36 min) =2.0 MET-h — a completely separate number answering "how much," not "how hard."

Same minutes, different MET-h

WHO/AHA define weekly dose in minutes — but two people hitting the same minutes at different intensities log very different volume:

150 min moderate @ 3.0 METs7.5 MET-h/week
150 min moderate @ 4.0 METs10 MET-h/week
75 min vigorous @ 6.0 METs7.5 MET-h/week
75 min vigorous @ 8.0 METs10 MET-h/week

METs tells you how intense an activity is; MET-h tells you how much of it you did. Verve computes both for every logged and background activity — METs decides its light/moderate/vigorous label, MET-h is its training volume.

Cardiorespiratory Fitness & MET

Why Verve treats CRF as the headline metric, VO₂Max as secondary

Video walkthrough — Cardiorespiratory Fitness

In production, coming soon

Ages 18–39: ACSM / Cooper Institute adult VO₂Max norms (1997), converted to METs.Ages 40+: Cleveland Clinic treadmill data (Mandsager 2018, 122,007 patients). Both use the same 5-tier system (Low → Elite) — Verve automatically selects the correct source based on your profile age.

Blair et al, JAMA 2009

33 studies, 102,980 participants. Each 1 MET improvement in CRF capacity is associated with a 13% reduction in all-cause mortality and 15% in cardiovascular mortality. Achieving 7.9 MET-hours/week is linked to substantially reduced cardiovascular mortality.

Mandsager et al, Cleveland Clinic 2018

122,007 patients. Being below vs above average CRF carries the same mortality risk as smoking or diabetes. Low to Elite CRF shows a 5-fold difference in all-cause mortality. Verve uses this data for ages 40+ and ACSM/Cooper Institute normative data for ages 18–39.

Kokkinos et al 2022

750,000 veterans, 10.2-year follow-up. Extremely fit vs lowest fitness shows a 4-fold mortality difference. No increased mortality seen at highest fitness levels.

Kim et al, UK Biobank

70,000+ participants. CRF and muscle strength together reduces mortality more than either alone. Strength training is a co-equal recommendation alongside aerobic activity.

AHA 2016 Scientific Statement

CRF should be regarded as a clinical vital sign, as predictive of health outcomes as blood pressure or cholesterol. Routine CRF assessment is recommended.

Why not VO₂Max? (Topol commentary)Commentary

234× more participants in MET-based CRF studies than VO₂Max studies. Over 99% of outcome data is based on METs. Wearable VO₂Max has 7–16% error and should not be used as a primary health metric.

Nakanishi et al 2021

Validates heart rate reserve (%HRR) + demographics for estimating MET intensity during free-living daily activity from wrist-worn wearables. Basis of Verve's Background Activity passive estimation.

Sedentary Behavior & Movement Balance

How Verve reads your day beyond workout minutes

Video walkthrough — Movement Balance

In production, coming soon

Sedentary Hours

Verve divides your day into one-hour slots from7am to 10pm. For each slot it reads your step count from Apple Health.

≥ 50 stepsActive
< 50 stepsSedentary
Before 7am / after 10pmSleep (not counted)

The 50-step threshold is intentionally low — even a short walk to the kitchen clears the hour. Apple Watch batches step data and syncs periodically, so today's count may dip and recover as earlier hours are updated.

Why hourly, not per-minute?Per-minute queries require HealthKit to process months of raw pedometer data at once — on most devices that query hangs indefinitely. Hourly data is pre-aggregated by iOS and returns instantly.

Standing Minutes · Apple Watch only

Apple Watch continuously monitors posture using its accelerometer and gyroscope. Verve reads Apple Stand Time — the raw cumulative minutes the Watch classified you as upright and moving.

This is not the green Stand ring. The ring counts hours where you stood for ≥1 minute (max 12/day). Standing Minutes counts the actual total — so 46 minutes across the day appears as 46, even if no single hour crossed the ring threshold.

Research shows total sedentary time and standing time are independent predictors of health outcomes — even for people who exercise regularly. Verve tracks both so you get the full picture beyond just workout minutes.

Biswas et al, Annals of Internal Medicine 2015

Meta-analysis of 47 studies, 240,818 person-years. Prolonged sedentary time is independently associated with all-cause mortality, cardiovascular disease, type 2 diabetes, and cancer — regardless of moderate-to-vigorous physical activity level. Participants in the highest quartile of sedentary time (≈10.6 h/day) had significantly elevated risk. Basis of Verve's first sedentary bar threshold at 10.6 h.

Ekelund et al, The Lancet 2016

Pooled analysis of 16 studies, 1,005,791 individuals. Sitting ≥8 h/day was associated with increased all-cause mortality unless offset by 60–75 min/day of moderate physical activity — a threshold most adults do not reach. Risk was highest above 12 h/day of total sedentary time, regardless of activity. Basis of Verve's second sedentary bar threshold at 12 h.

Patterson et al, BMJ 2018

Systematic review and meta-analysis of 13 prospective studies, 1,020,840 person-years. High sedentary time is associated with a 24% greater all-cause mortality risk, 14% greater CVD mortality risk, and 17% greater cancer risk, independent of physical activity. Risk increases steeply above 10 h/day.

Diaz et al, Annals of Internal Medicine 2017

7,985 adults followed for 4 years. Total sedentary time AND uninterrupted sitting bouts both independently predict mortality. Frequent breaks from sitting are protective even for those with the same total sedentary hours — supporting the importance of how sitting is distributed, not just how much.

Step Count & Daily Movement

Daily step tiers and cadence zones

Video walkthrough — Steps & Cadence

In production, coming soon

Zone 2 Training

The weekly target, and the personal heart-rate band behind it

Video walkthrough — Zone 2 Training

In production, coming soon

Heart-rate method: Karvonen HRR

"Zone 2" is a training label applied to the 40–60% Heart Rate Reserve band — different models (Seiler polarised, Maffetone 180-minus-age, San Millán VT1-based) draw the upper boundary slightly differently, but all target the same physiological space just below the first ventilatory threshold.

Heart Health

ApoB · LDL-C · Lp(a) · hs-CRP — screening bands, not treatment targets

Video walkthrough — Heart Health

In production, coming soon

For ApoB and LDL-C in particular, clinical targets are set by a person's overall cardiovascular risk category — a value in the "borderline" band may be perfectly appropriate for one person and a treatment trigger for another. Verve classifies against population screening bands and always defers to a clinician.

Body Phenotyping

Metabolic syndrome screening, beyond BMI

Video walkthrough — Body Phenotyping

In production, coming soon

Muscle Health & Grip Strength

Why grip strength is in a fitness app at all

Video walkthrough — Muscle Health & Grip Strength

In production, coming soon