Definitions: Health, Fitness, and Physical Activity

A Note From the Editors

In 1993, with the special assistance of Chris Spain, Director of Research, Program Planning, and Special Projects for
the Council, we brought back the Presidents Council on Physical Fitness and Sports Research Digest that was
originally published by the Council under the editorship of H. Harrison Clarke. As young professionals we remember
reading the Digest and admiring the way Dr. Clarke was able to take complex information and make it simple to
understand. We also remember that Dr. Clarke would bring together information from multiple sources and synthesize it
for use by practitioners.
For this first issue of the new century we decided follow Dr. Clarkes lead and draw together definitions of terms
commonly used in our field. Over the past 50 years there has been considerable change in the definitions of terms such
as physical fitness and even health. New terms have evolved such as wellness and metabolic fitness. We have asked Dr.
Don Franks, known for his synthesizing abilities, to help us write this special issue. We dedicate this issue, as we did
our first in 1993, to the memory of Dr. Clarke.
Introduction
H. Harrison Clarke was one of the first to write extensively about health related physical fitness. Indeed, we would
consider him and his contemporaries such as Tom Cureton, Wilhelm Raab and Arthur Steinhaus as the leaders in
changing the way we view physical fitness today. The definition of fitness in 1958, when the first national youth fitness
test was developed is considerably different from our current definition of physical fitness. In addition, new terms have
been developed such as metabolic fitness and wellness. Landmark documents such as the Healthy People series of
national health objectives (U.S. Department of Health & Human Services, 2000; U.S. Department of Health & Human
Services, 1990; U.S. Department of Health, Education, & Welfare, 1979) have helped standardize some terms as have
other documents such at the two international consensus conference volumes (Bouchard, et al., 1990, 1994) and the
more recent Surgeon Generals Report on Physical Activity and Health (U.S. Department of Health & Human Services,
1996). We have drawn from these and other sources some common current definitions for key terms in our field. We
focus on those terms that typically reoccur in the Digest from issue to issue. It is not our intent to suggest that the terms,
as defined in this document, are the only definitions that are appropriate for use. Neither is it our intent to suggest that
the terms defined in this issue is a comprehensive list of all relevant terms. Rather, it is our notion to define some of the
most commonly used terms in the field (and commonly used in the Digest) and to use definitions that are consistent
with experts in our field.
Product vs. Process
For ease of understanding, we have grouped the definitions in two broad categories: Product and Process. Products refer
to states of being such as physical fitness, health and wellness. These are also commonly referred to as outcomes and
they are frequently used as dependent measures in research. Process refers to behaviors or lifestyles and these are
frequently used as independent measures for research purposes. Examples of processes or lifestyle behaviors are
physical activity, exercise, sports, dance, etc.

Product Definitions
Physical Fitness
A set of attributes that people have or achieve relating to their ability to perform physical activity (U.S.
Department of Health & Human Services, 1996).
Comment: The above definition from Physical Activity and Health: A Report of the Surgeon General is the most
common currently used definition of physical fitness. It was originally used by Caspersen, et al. (1985) and has been
used extensively by Pate et al (1995) and Howley and Franks (1997). An alternative definition that provides additional
descriptive information is also included here. Physical fitness is a state of well-being with low risk of premature health
problems and energy to participate in a variety of physical activities (Howley & Franks, 1997). While either is a good
definition, most experts agree that physical fitness is both multidimensional and hierarchical (Corbin, 1991). Bouchard,
Shephard, and Stephens (1994) presented a comprehensive model for physical fitness that includes morphological
fitness, bone strength, muscular fitness, flexibility, motor fitness, cardiovascular fitness, and metabolic fitness. In this
paper we define each of these fitness components but use a simple multidimensional hierarchical model (see Figure 1)
that is consistent with recent definitions in the literature (ACSM, 1998; USDHHS, 1996; USDHHS, 2000).

Physical Fitness

Skills

Physiological

Health-Related

Skill-Related

Sports

Metabolic

Body Composition

Agility

Team

Morphological

Cardiovascular Fitness

Balance

Individual

Bone Integrity

Flexibility

Lifetime

Other

Muscular Endurance
Muscle Strength

Coordination
Power
Speed
Reaction Time
Other

Other

Figure 1. Common Physical Fitness and Fitness Related Terms

Health-Related Physical Fitness

Health-related physical fitness consists of those components of physical fitness that have a relationship with good
health. The components are commonly defined as body composition, cardiovascular fitness, flexibility, muscular
endurance, and strength.
Comment: Prior to the last 40 years the distinction between health-related physical fitness and skill-related physical
fitness was not typically made. When tests of physical fitness are administered in school, medical and other settings it is
typically health-related fitness components that are measured. Typically lab and field tests of health-related fitness
involve some type of performance such as running, stretching, or doing a specific muscle exercise. Because body
composition (also referred to as relative leanness) is not a performance measure, some question its inclusion as a
component of health-related physical fitness. Possessing good health-related fitness is related to lower risk of illness and
improved quality of life.

Body Composition
A health-related component of physical fitness that relates to the relative amounts of muscle, fat, bone and other
vital parts of the body (From Surgeon Generals Report on Physical Activity and Health, USDHHS, 1996 as adapted
from Corbin and Lindsey, 1994).
Comment: This component of physical fitness is measured in the laboratory using such measures as underwater
weighing and in the field using skinfold calipers. There are a variety of other methods of assessing body composition;
also referred to as relative leanness (Howley and Franks, 1997). As noted previously body composition is the only nonperformance measure among the health-related physical fitness components.

Cardiovascular Fitness
A health-related component of physical fitness that relates to ability of the circulatory and respiratory systems to
supply oxygen during sustained physical activity (From Surgeon Generals Report on Physical Activity and Health,
USDHHS, 1996 as adapted from Corbin and Lindsey, 1994).
Comment: Cardiovascular fitness is also referred to as cardiovascular endurance, aerobic fitness and cardiorespiratory
fitness. A Max VO2 test in the laboratory setting is considered to be the best measure of cardiovascular fitness.
Commonly administered field tests include the mile run, the 12 minute run, the 1 mile run, the mile walk, the PACER
run for children and various bicycle, step, and treadmill tests.

Flexibility
A health-related component of physical fitness that relates to the range of motion available at a joint (From
Surgeon Generals Report on Physical Activity and Health, USDHHS, 1996 as adapted from Wilmore and Costill,
1994).
Comment: Some experts specifiy that flexibility requires range of motion without discomfort or pain (Howley and
Franks, 1997).Flexibility is specific to each joint of the body, thus there is no general measurement of flexibility as there
is for cardiovascular fitness. Flexibility is typically measured in the lab using measurement devices such as a
goniometer, flexometer and in the field with tests such as the sit and reach and the zipper.

Muscular Endurance
A health-related component of physical fitness that relates to the muscles ability to continue to perform without
fatigue (From Surgeon Generals Report on Physical Activity and Health, USDHHS, 1996 as adapted from Wilmore
and Costill, 1994).
Comment: Like flexibility, muscular endurance is specific in nature. For true assessment of muscular endurance it
would be necessary to test each major muscle group of the body. Lab and field tests of muscular endurance are similar
and are based on the number of repetitions that can be performed by the specific muscle group being tested (example:
repetitions of push-ups or abdominal curls. Muscular endurance can be measured isometrically (static contractions) or
isotonically (dynamic contractions).

Strength
A health-related component of physical fitness that relates to the ability of the muscle to exert force (From
Surgeon Generals Report on Physical Activity and Health, USDHHS, 1996 as adapted from Wilmore and Costill,
1994).
Comment: Like flexibility and muscular endurance, strength is specific in nature. For true assessment it would be
necessary to test each major muscle group of the body. Lab and field tests are similar and involve the assessment of one
repetition maximum (the maximum amount of resistance you can overcome one time). 1RM tests are typically
conducted on resistance machines. Strength can also be assessed using dynamometers. Strength can be measured
isometrically (static contractions) or isotonically (dynamic contractions).

Skill-related Physical Fitness

Skill-related physical fitness consists of those components of physical fitness that have a relationship with
enhanced performance in sports and motor skills. The components are commonly defined as agility, balance,
coordination, power, speed and reaction time.
Comment: With the changing focus to health-related physical fitness those components of fitness previously included in
fitness tests that are not directly related to improved health were designated as skill-related physical fitness components.
Possession of skill-related fitness abilities enhances ability to perform in sports and games but only has an indirect
connection with health. The skill-related components of fitness are considered to be agility, balance, coordination,
power, speed, and reaction time though some experts feel that other abilities such as visual tracking should be included.
It is assumed that people who possess skill-related fitness will be more likely to engage in regular activity and for this
reason will have enhanced health-related fitness and a lower risk of hypokinetic diseases and condition (see later
definition). Skill-related fitness components are assessed with performance measures. Such components as reaction time
and speed are considered by some to be more related to heredity than healthy lifestyles, especially in children.

Agility
A skill-related component of physical fitness that relates to the ability to rapidly change the position of the entire
body in space with speed and accuracy (From Surgeon Generals Report on Physical Activity and Health, USDHHS,
1996 as adapted from Corbin and Lindsey, 1994).
Comment: Agility is typically measured using a shuttle or zig-zag run. Tests of agility are common as screening tests
among sports teams.

Balance
A skill-related component of physical fitness that relates to the maintenance of equilibrium while stationary or
moving. (From Surgeon Generals Report on Physical Activity and Health, USDHHS, 1996 as adapted from Corbin and
Lindsey, 1994).
Comment: Balance is typically measured using a balance beam or tests that require holding a stationary posture after
changing body positions. Balance is generally considered to be of two types; static and dynamic.

Coordination
A skill-related component of physical fitness that relates to the ability to use the senses, such as sight and hearing,
together with body parts in performing motor tasks smoothly and accurately. (From Surgeon Generals Report on
Physical Activity and Health, USDHHS, 1996 as adapted from Corbin and Lindsey, 1994).
Comment: Coordination is typically assessed using measures of hand-eye or foot-eye coordination such as juggling,
dribbling a ball or hitting an object. There are, however, many different types of coordination and total assessment of
coordination would require many different tests.

Power
A skill-related component of physical fitness that relates to the ability to the rate at which one can perform work.
(From
Surgeon
Generals
Report
on
Physical
Activity
and
Health,
USDHHS,
1996.)
Comment: Power is considered to be a combination of strength and speed. It has also been defined as the ability to exert
muscle force quickly (Howley and Franks). For this reason some consider it to be a combination of skill and healthrelated physical fitness. Examples of power include putting the shot and vertical jumping. There are, however, many
different types of power and total assessment would require many different tests.

Speed
A skill-related component of physical fitness that relates to the ability to perform a movement within a short
period of time. (From Surgeon Generals Report on Physical Activity and Health, USDHHS, 1996 as adapted from
Corbin and Lindsey, 1994).
Comment: There are many different types of speed such as running speed, swimming speed, speed of hand or foot
movement to name but a few. Among athletes a 40 yard dash is often used to measure speed. There are a wide variety of
laboratory measures of speed that are highly specific to different body parts and different human movement activities.

Reaction Time
A skill-related component of physical fitness that relates to the time elapsed between stimulation and the
beginning of the reaction to it. (From Surgeon Generals Report on Physical Activity and Health, USDHHS, 1996 as
adapted from Corbin and Lindsey, 1994).
Comment: An example of reaction time is moving your foot from the accelerator to the brake pedal when reacting to a
situation that requires a person to stop a car. This example illustrates the fact that in many cases, the total response time
is the more important variable. Total response time includes stimulus to beginning of movement (reaction time) to end
of movement (movement time). Like other measures of skill-related fitness there are many different types of reaction
time and total assessment of reaction time would require many different tests. Sophisticated timing devices are used to
measure total response time in the lab. Like speed, reaction time is considered to be a component of fitness that is
greatly influenced by heredity. Note: The authors of this paper, not Bouchard, et al. (1990) have classified these as
subcomponents of physiological fitness.

Physiological Fitness
Physiological fitness includes non-performance components of physical fitness that relate to biological systems
that are influenced by ones level of habitual physical activity. (adapted from Bouchard, et al., 1990).
Comment: The concept of physiological fitness was introduced in a publication of the first international consensus
statement of current knowledge of physical activity (Bouchard, et al., 1990). It differentiated health-related (primarily
performance measures) from non-performance measures. Some of these measures are defined below. Some of the subcomponents of physiological fitness that have gained acceptance are metabolic fitness, morphological fitness, and bone
integrity.

Metabolic Fitness
The state of metabolic systems and variables predictive of the risk for diabetes and cardiovascular disease which
can be favorably altered by increased physical activity or regular endurance exercise without the requirement of
a training-related increase inVO2max. (Adapted from the American College of Sports Medicine, 1998).
Comment: Though Depres, et al. (1990, 1991) are first credited with using the term metabolic fitness it was first used
widely after it was described in the proceedings of the second International Consensus Conference on Physical Activity,
Fitness and Health (Bouchard, et al, 1994). The use of the term metabolic fitness in the recent position statement
describing the quality and quantity of physical activity needed to attain health-related benefits (ACSM, 1998)
establishes it as a major fitness component. The International Consensus statement noted that metabolic fitness included
such sub-components as blood sugar levels, blood lipid levels, and blood hormone levels. The reason for the
identification of metabolic fitness as a separate component of fitness is because it is now clear that lower levels of
physical activity (particularly intensity) than recommended (by this position stand) may reduce the risk for certain
chronic degenerative diseases and improve metabolic fitness and yet may not be of sufficient quantity or quality to
improve VO2max. (ACSM, 1998).

Morphological Fitness
A non-performance component of fitness related to body composition factors such as body circumferences, body
fat content, and regional body fat distribution (adapted from Bouchard, et al., 1994).
Comment: Morphological fitness measures are often related to metabolic fitness components. As noted earlier body
composition is often included as a component of health-related fitness but is also appropriately considered a component
of morphological fitness. Those measures used to assess body composition are also used to assess morphological fitness
as are measures such as body mass index, waist circumference, and waist to hip ratio.

Bone Integrity (Bone Strength)

A non-performance component of fitness related to bone mineral density.
Comment: Bone strength was identified as a component of physical fitness in the first International Consensus
Statement (Bouchard, 1990). Because measurement is expensive and requires special instrumentation and a high degree
of expertise, there are no currently used field measures that are used extensively. There is general consensus, however,
that bone integrity is related to habitual physical activity.

Motor Skills
Motor skills are non-fitness abilities that improve with practice (learning) and relate to ones ability to perform
specific sports and other motor tasks.
Comment: Though motor skills are not considered to be part of physical fitness, they are related to successful
performance in physical activity. Motor skills are sometimes confused with skill-related fitness abilities. In fact, they are
quite different. Skill-related fitness components enhance ones ability to learn sports and motor skills quickly and are
related to ones ability to achieve high level performance. Examples of motor skills are a tennis serve, shooting a
basketball, and kicking a football. A line (See Figure 1) is used to indicate the fact that motor skills are not components
of physical fitness. There are many different kinds of motor skills only those associated with sports are included in
Figure 1.

Health Definitions
Hypokinetic Diseases or Conditions
Hypokinetic diseases are conditions related to inactivity or low levels of habitual activity.
Comment: The term hypokinetic was coined by Kraus and Raab in their book Hypokinetic Disease (Kraus & Raab,
1961). This term is now widely accepted and can be used to describe many of the diseases and conditions associated
with inactivity and poor fitness such as those conditions outlined in Physical Activity and Health: A Report of the
Surgeon General (USDHSS, 1996).

Health
Health is a state of being associated with freedom from disease and illness that also includes a positive component
(wellness) that is associated with a quality of life and positive well-being. (Adapted from Corbin, Lindsey, & Welk,
2000; Bouchard, et al., 1990).
Comment: More than 50 years ago the World Health Organization defined health as more than freedom from illness,
disease, and debilitating conditions. Recent public health documents (USDHHS, 2000) have acknowledged the positive
component of health (wellness).

Wellness
Wellness is a state of being describing a state of positive health in the individual and comprising biological and
psyschological well-being as exemplified by quality of life and a sense of well-being. (Adapted from Corbin,
Lindsey, & Welk, 2000; Bouchard, et al., 1990; USDHHS, 2000).
Comment: The suggestion by the World Health Organization that health had a positive component led to the use of the
term wellness. The term wellness is now widely used to describe the state of being representing the positive component
of health (Corbin, Lindsey & Welk, 2000; USDHHS, 2000). The Health Goals for the Nation for the Year 2010
(USDHHS, 2000) uses quality of life measures such as self-rated health, a healthy days index, and an activity days
indicators of health and wellness. Other wellness or quality of life indicators include vitality, hardiness, and vigor. For
more information on the assessment of health and wellness the reader is referred to Caspersen, et al., 1995).

Quality of Life
A term that connotes an overall sense of well being. (USDHHS, 2000).
Comment: Kaplan and Bush (1982) introduced the term health-related quality of life (HRQL). However, for public
health use, two types of global quality of life are identified: health-related quality of life and quality of life (not health
related). Health related quality of life is limited to those aspects that can clearly be shown to affect mental or physical
health. Examples include functional status and well-being. Non-health related quality of life includes such factors as
happiness and life satisfaction. Individual quality of life is identified as related to specific people or individuals.
Community quality of life relates to groups of people or communities (USDHHS, 2000).

Process Definitions:
Healthy Lifestyles or Behaviors
There are many healthy lifestyles or behaviors that contribute to fitness, health and wellness. In this paper the processes
or healthy lifestyles that are defined relate only to one healthy lifestyle: physical activity. The importance of other
healthy lifestyles such as nutrition and stress management is acknowledged but is beyond the scope of this paper.
Physical Activity
Bodily movement that is produced by the contraction of skeletal muscle and that substantially increases energy
expenditure. (Adapted from USDHHS, 1996; Bouchard, et al., 1990).
Comment: The first International Consensus statement on physical activity, fitness and health suggested that physical
activity was an umbrella term (see Figure 2) that was that had multiple dimensions. Forms of physical activity such as
exercise, sports, dance (among others) are considered as sub-categories of physical activity. Only selected forms of
physical activity, including those defined in the first international consensus statement are defined here.

Exercise (training)
Exercise is leisure time physical activity conducted with the intention of developing physical fitness (Adapted from
Bouchard, et al., 1990).
Comment: Since the first International Consensus statement on physical activity, fitness and health the distinction has
been made between physical activity and exercise noting that exercise is a specific form of physical activity dedicated
to improving physical fitness. Physical training is another term that is used as a synonym for exercise.

Leisure Activity
Leisure activity is physical activity undertaken during discretionary time (Adapted from Bouchard, et al., 1990).
Comment: Research in physical activity often separates leisure physical activity from vocational activity. Leisure
activity includes exercise but all forms of leisure activities are not exercise

Concluding Comments
Our purpose in preparing of this issue of the Digest was to define some of the key terms of our field. We learned in the
closing years of the past century that new terms have evolved. In this issue of the Digest we draw on several of the most
recent public documents relating to health and physical activity to come up with a compendium of terms that can be
used by practitioners.
Figure 3 is included here because it helps to tie together several of the terms defined in this paper. The model adapted
from the first consensus on physical activity, fitness and health shows the link between product and process, as well as
the link between fitness and health and wellness. It also illustrates the fact that physical activity is not the only factor
that influences fitness, health and wellness. Clearly fitness, health and wellness are greatly influenced by factors other
than physical activity, such as heredity (Bouchard, et al., 1990). Figure 3 also illustrates that other processes (lifestyles
or behaviors) also have an impact on fitness health and wellness, as do environmental factors and personal attributes.
It is our hope that this synthesis of information will be helpful in your efforts to promote physical activity and other
healthy lifestyles as a means of improving fitness, health and wellness in the years ahead.
The Presidents Council on Physical Fitness and Sports Research Digest is now available on-line at
http://www.indiana.edu/~preschal
Please note that the appropriate language for the citation of this resource is: The Presidents Council on Physical Fitness
and Sports Research Digest.

Physical Activity and Fitness Quote

Physical activity is a healthy lifestyle that is among the most
important for promoting physical fitness, health and
wellness.
Charles B. Corbin, Ph.D. and Robert P. Pangrazi, Ph.D. - Arizona State University, Tempe, Arizona
B. Don Frank, Ph.D. - University of Maryland, College Park, MD
Please Post:
Presidents Council on Physical Fitness & Sports
200 Independence Avenue, S.W., Washington, DC 20201
(202) 690-9000 FAX (202) 690-5211
The Presidents Council on Physical Fitness and Sports
The Presidents Council on Physical Fitness and Sports (PCPFS) was established in 1956 through an Executive
Order by President Dwight D. Eisenhower as part of a national campaign to help shape up Americas younger
generation. Today, the PCPFS serves as an advisory council to the President and Secretary of the Department of
Health & Human Services on matters involving physical activity, fitness and sports to enhance and improve the
health of Americans of all ages.
The PCPFS enlists the active support and assistance of individual citizens, civic groups, private enterprise, and
voluntary organizations to promote and improve the physical activity and fitness of all Americans and to inform the
public of the important link which exists between regular activity and good health.
Twenty (20) individuals from the sports, fitness and health fields are appointed by the President to serve as members
of the Council. They are:
Lee Haney, Chairman
Elizabeth Arendt, M.D., St. Paul, MN
Jeff Blatnick, Halfmoon, NY
Ralph Boston, Knoxville, TN
Don Casey, East Rutherford, NJ
Timothy Finchem, Ponte Vedra Beach, FL
Rockne Freitas, Ed.D., Honolulu, HI

Zina Garrison, Houston, TX

Jimmie Heuga, Avon, CO
Jim Kelly, Buffalo, NY
Judith Pinero Kieffer, Los Angeles, CA
Deborah Slaner Larkin, Pelham, NY
Nikki McCray, Washington, D.C.
Albert Mead III, Atlanta, GA

Jack Mills, Columbia, SC

Ellen Hart Pea, Denver, CO
Ken Preminger, Atherton, CA
Amber Travsky, Laramie, WY
Executive DirectorSandra Perlmutter
Two (2) vacancies

200 Independence Avenue, S.W., Washington, DC 20201 (202) 690-9000 FAX (202) 690-5211

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Published quarterly by the Presidents Council on Physical Fitness and Sports - Washington, D.C.
Guest Authors:
Dr. Charles B. Corbin Dr. Robert P. Pangrazi - Arizona State University Tempe, AZ
Dr. B. Don Franks - University of Maryland - College Park, MD