1. ^*Department of Biomedical Science, University of Wollongong, Wollongong, Australia
2. ^†Department of Human Biology, Maastricht University, Maastricht, The Netherlands

Correspondence: Klaas R. Westerterp Department of Human Biology, University of Maastricht, PO Box 616, 6200MD Maastricht, The Netherlands. E-mail: k.westerterp@hb.unimaas.nl

^**The costs of publication of this article were defrayed, in part, by the payment of page charges. This article must, therefore, be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

Received 12 April 2006; Accepted 26 February 2007.

Abstract

This review focuses on the ability of different accelerometers to assess daily physical activity as compared with the doubly labeled water (DLW) technique, which is considered the gold standard for measuring energy expenditure under free-living conditions. The PubMed Central database (U.S. NIH free digital archive of biomedical and life sciences journal literature) was searched using the following key words: doubly or double labeled or labeled water in combination with accelerometer, accelerometry, motion sensor, or activity monitor. In total, 41 articles were identified, and screening the articles' references resulted in one extra article. Of these, 28 contained sufficient and new data. Eight different accelerometers were identified: 3 uniaxial (the Lifecorder, the Caltrac, and the CSA/MTI/Actigraph), one biaxial (the Actiwatch AW16), 2 triaxial (the Tritrac-R3D and the Tracmor), one device based on two position sensors and two motion sensors (ActiReg), and the foot-ground contact pedometer. Many studies showed poor results. Only a few mentioned partial correlations for accelerometer counts or the increase in R² caused by the accelerometer. The correlation between the two methods was often driven by subject characteristics such as body weight. In addition, standard errors or limits of agreement were often large or not presented. The CSA/MTI/Actigraph and the Tracmor were the two most extensively validated accelerometers. The best results were found for the Tracmor; however, this accelerometer is not yet commercially available. Of those commercially available, only the CSA/MTI/Actigraph has been proven to correlate reasonably with DLW-derived energy expenditure.