Impact of daily step count on glycemic outcomes of community residents with impaired glucose tolerance / 中华健康管理学杂志

Objective:To investigate the impact of daily step count on glycemic outcomes in community residents with impaired glucose tolerance (IGT).Methods:This was a prospective cohort study, in October 2018, 204 residents who met the criteria of IGT were recruited in the Shijingshan District in Beijing. The subjects were tested for fasting blood glucose, oral glucose tolerance test 2-hour blood glucose (2hBG), glycated hemoglobin A 1c (HbA 1c), lipid profile, liver and kidney function, as well as measurements of height, weight and waist circumference. A dedicated mobile application was used to deliver prediabetes health knowledge monthly. Online guidance was provided to answer questions and daily step count was collected using the application. Three years later, a follow-up was conducted to assess the participants′ glycemic outcomes and other indexes, and a total of 142 participants completed the follow-up review. According to daily step count, the subjects were categorized into high step count group (42 cases,>7 000 steps daily), moderate step count group (54 cases, 5 000-7 000 steps daily), and low step count group (46 cases,<5 000 steps daily). Subjects were categorized into diabetes group (30 cases), prediabetes group (77 cases) and normal glucose tolerance group (35 cases) with glycemic outcomes. Independent sample t test was used to compare the differences in blood glucose, blood lipids, and step counts between the two groups. Kruskal-Wallis H test or one-way ANOVA was used to compare the differences in blood glucose, blood lipids, and step counts between multiple groups. The χ2 test was used to compare the differences in glycemic outcomes between multiple groups. Multivariate logistic regression analysis was used to assess the impact of daily step counts and body mass index on glycemic outcomes. Linear regression analysis was used to evaluate the relationship between daily step counts and 2 h BG. Results:A total of 142 participants completed the 3-year follow-up, including 43 males and 99 females, with a mean age of (60.15±5.67) years. At baseline, males had significantly higher body mass index, waist circumference, and fasting blood glucose when compared to those in females [(26.97±2.43) vs (24.89±2.93) kg/m 2, (92.68±7.75) vs (83.83±8.60) cm, (5.83±0.61) vs (5.62±0.52) mmol/L], the total cholesterol and HDL-C were also significantly lower in males than those in females [(5.10±1.16) vs (5.55±0.95) mmol/L, (1.35±0.34) vs (1.56±0.35) mmol/L] (all P<0.05). After 3-year follow-up, 21.1% (30/142) of IGT participants progressed to diabetes, with an annual conversion rate of approximately 7%. The normal glucose tolerance group showed significantly higher daily step counts when compared with the prediabetes and diabetes groups [(7 886±2 867) vs (5 981±2 655) vs (4 117±2 674) steps] ( H=31.778, P<0.001). Individuals with higher daily step counts exhibited lower body mass index, 2 h BG, and HbA 1c level when compared with those in the ones with moderate and low step counts [(24.26±3.09) vs (25.44±3.38) vs (26.26±3.59) kg/m 2, (7.50±1.71) vs (9.15±3.30) vs (11.19±3.84) mmol/L, 5.97%±0.46% vs 6.14%±0.99% vs 6.40%±0.96%] (all P<0.05). Higher step count was positively correlated with the reversal of prediabetes to normal blood glucose levels (moderate step count, OR=0.297, 95% CI: 0.109-0.804; low step count, OR=0.055, 95% CI: 0.010-0.287), lower daily step count correlated positively with prediabetes progressing to diabetes ( OR=4.857, 95% CI: 1.140-20.689) (all P<0.05). For every additional 1 000 steps per day, the 2 h BG decreased by 0.5 mmol/L. Conclusion:As daily step count increases, the glucose metabolism improves in IGT community residents. Higher daily step count is associated with reversal of IGT to normal glucose tolerance, while lower daily step count may be associated with the progression of IGT to diabetes.

Daily steps corresponding to the reference quantity of physical activity of Exercise and Physical Activity Reference for Health Promotion 2006 (EPAR2006) assessed by accelerometer / 体力科学

The purpose of this study was to determine daily steps corresponding to the reference value for the quantity of Physical Activity and Exercise for Health Promotion 2006 (23 METs·h/wk) considering non-locomotive activities. Two hundred and thirty one men and 224 women wore a tri-axial accelerometer for two weeks. We analyzed the data in each age group (young (less than 40 years), middle-aged (40 to 59 years), and elderly (60 years or more) groups), also. There were significant relationships between daily steps and locomotive activity (r = 0.762 to 0.820, p < 0.001) and total (locomotive and non-locomotive) physical activity (r = 0.706 to 0.824, p < 0.001) with intensity of 3 METs or more in all groups. The daily steps corresponding to 23 METs·h/wk, calculated using regression lines between the daily steps and total physical activities with intensity of 3 METs or more in men and women were 6,534 steps/d and 6,119 steps/d. On the other hand, the daily steps corresponding to 23 METs·h/wk, calculated using regression lines between the daily steps and locomotive activities with intensity of 3 METs or more in men and women were 7,888 steps/d and 8,584 steps/d. These results suggest that non-locomotive activity should also be taken into consideration in the case of assessment of a daily physical activity.

Padrão usual de passos diários de indivíduos com atividade profissional administrativa pública / Usual pattern of daily steps among federal public workers

INTRODUÇÃO: Programas de promoção da atividade física têm empregado o pedômetro como instrumento de quantificação de passos diários acumulados pelos participantes. Entretanto, praticamente inexiste a caracterização de padrões habituais de passos de trabalhadores brasileiros. OBJETIVO: Caracterizar o padrão usual de passos caminhados por servidores públicos com atividade profissional administrativa. MÉTODOS: Foram avaliados 46 voluntários (24% homens), com média de idade e índice de massa corporal (IMC) de 39,5±7,8 anos e IMC 24,0±3,0 kg/m2, selecionados aleatoriamente em um órgão do Poder Judiciário, em Brasília-DF. Para quantificação dos passos empregou-se pedômetro Digi-Walker-SW700, consecutivamente nos 7 dias da semana, para todo o grupo e segundo o nível de atividade física e gênero. As comparações empregaram os testes de Kruskal-Wallis e de Mann-Whitney quando apropriados e a relação entre o IMC e o número de passos foi verificada pela correlação de Spearman (rs). RESULTADOS: A mediana (extremos) de passos diários foi de 7266 (1630 – 13714). Não houve diferença entre o número de passos acumulados nos dias úteis (DU) (7508; 2038 – 15109) e nos finais de semana/feriados (FS/F) (6674; 747 – 14918) (p = 0,46). O mesmo se observou na comparação dos passos entre DU e FS/F nos indivíduos ativos (p=0,17), sedentários (p=0,99), homens (p=0,87) e mulheres (p=0,58). Houve correlação negativa entre o IMC e os passos acumulados nos FS/F (rs= -0,35;p=0,02), mas não nos DU (rs= -0,01;p=0,94). CONCLUSÕES: O número usual de passos diários da amostra estudada mostrou mediana significativamente menor que o referencial recomendado de 10.000 passos, com distintos padrões quanto ao gênero e atividade física dos indivíduos. Descritores: atividade física, pedômetro, número de passos diários, sedentarismo.

BACKGROUND: Pedometers have been used in physical activity programs as a measurement tool for quantification of the participants’ accumulated daily steps. However, the characterization of habitual daily steps patterns of Brazilian workers' is practically inexistent. OBJECTIVE: To characterize the usual daily steps pattern of civil servants with administrative professional activity. METHODS: Forty six volunteers (24% men), age and body mass index (BMI) average ± SD of 39.5±7.8 yrs and 24.0±3.0 kg/m2, were randomly selected from a Federal Court institution, in Brasília-DF. Daily steps were recorded with the Digi-Walker-SW700 pedometer, consecutively in the 7 days of the week, for the whole group and according to the baseline physical activity level and the gender. For all the comparisons Kruskal-Wallis and Mann-Whitney tests were used when appropriate and the relationship between BMI and the number of daily steps was analyzed by the Spearman's correlation (rs). RESULTS: Median (lower and upper limits) of daily steps was 7266 (1630 - 13714). There was no difference between the number of accumulated steps in the week days (WD) (7508; 2038 - 15109) and in the weekend/holidays (WK/H) (6674; 747 - 14918) (p = 0.46). The same was observed in the comparison between WD versus WK/H in the active subjects (p=0.17), in sedentary (p=0.99), in men (p=0.87) and in women (p=0.58). There was a negative correlation between BMI and the accumulated steps on WK/H (rs = -0.35;p=0.02), but not on the WD (rs = -0.01;p=0.94). CONCLUSIONS: The usual number of daily steps of the studied sample showed median significantly smaller than the recommended 10.000 steps/day target, with different patterns as for the gender and the individuals' physical activity level.

Adesão a um programa de atividade física baseado no incremento do número de passos diários, por homens saudáveis sedentários / Adherence to a physical activity program based on daily steps number increment by sedentary healthy men

O sedentarismo é um problema de saúde pública e um dos principais fatores modifi cáveis de risco cardiovascular. O aumento do nível de atividade física é um enorme desafi o, para o qual intervenções práticas e de baixo custo devem ser avaliadas. Objetivos: Avaliar a adesão a uma intervenção para aumento da atividade física baseada no incremento, em curto prazo, de 3500 passos diários acima do habitual. MÉTODOS: Foram estudados 19 homens saudáveis, insufi cientemente ativos, entre 19 e 46 anos e índice de massa corporal de 24,6±2,7 Kg/m2. Para quantifi cação do número de passos diários empregou-se pedômetro Yamax-SW700. O padrão habitual de passos diários foi quantifi cado por duas semanas, após o que foi instituído, durante três semanas, incremento de 3500 passos/dia acima da média habitual. A meta da intervenção foi constatada pela comparação pareada entre o número de passos/dia acumulados nas duas fases do estudo, por meio do teste de Wilcoxon. A adesão à intervenção foi avaliada pelo porcentual de cumprimento da meta de passos instituída. O nível de signifi cância estatística foi estabelecido como p < 0,05. RESULTADOS: A mediana (extremos) dos passos diários durante a intervenção foi superior (11772; 8998 – 18620) ao habitualmente acumulado (7295; 4700 – 14752) (p=0,0001). A mediana do porcentual de cumprimento da meta foi 106,2% (83,4 – 119,9%). Conclusão: A intervenção de incremento de 3500 passos diários mostrou-se exequível e de elevada adesão, no curto prazo, para aumento da atividade física, representando uma alternativa para programas e políticas de combate ao sedentarismo, ao menos para indivíduos saudáveis sedentários.

Background: Inactivity is a public health problem and one of the main modifi able cardiovascular risk factors. The increase in the level of physical activity represents an enormous challenge. In that sense, practical and low-cost interventions must be evaluated. OBJECTIVES: In this study, we assessed the adherence, in the short term, to an increasing physical activity intervention based on the increment of 3,500 daily steps above the usual. METHODS: We studied 19 men, insuffi ciently active (aged 19-46, BMI = 24.6 ± 2.7Kg/m2) using Yamax- SW700 pedometer. The usual pattern of daily steps was quantifi ed during two weeks, after which, an increase of 3,500 steps/day, above the average usually accumulated during week days, was determined for three weeks. The adherence to the intervention was verifi ed by paired comparison of accumulated steps/day, in the two phases of the study, by means of the Wilcoxon test, as well as by the calculation of the percent accomplishment of the established target. RESULTS: The median (extremes) of daily steps during the intervention phase was higher (11772; 8998 – 18620) than the usually accumulated (7295; 4700 – 14752) (p=0.0001). The percent median of the target accomplishment was 106.2% (83.4 – 119.9%), surpassing the increase established. CONCLUSIONS: The intervention of 3,500 daily steps increase proved both feasible and effi cient, in the short term, to increase the level of physical activity, representing a practical and feasible option for programs and policies to fi ght sedentarism, at least for sedentary healthy men.

RELATIONSHIP BETWEEN DAILY STEPS AND PHYSICAL FITNESS IN COMMUNITY-DWELLING ELDERY / 体力科学

The purpose of this study was to examine the association between the pedometer-determined steps per day and physical fitness in order to evaluate the usefulness of the pedometer-determined physical activity to help individuals meet the recommended exercise target level of the Ministry of Health, Labour and Welfare (MHLW). The subjects consisted of 222 men and 172 women aged 71 years in community-dwelling elderly. The subjects wore a pedometer for 7 consecutive days to measure daily steps. The functional capacity was assessed based on the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) and self-reported performance of tasks (stair-climbing and chair-rising). Physical fitness tests included handgrip strength, knee extensor strength, leg extensor power, stepping, one-leg standing time with eyes open and maximal walking speed at 10 m. The men and women took on average 6,561±2,907 and 6,329±2,451 steps/day, respectively. Our subjects seemed to be highly functioning elderly, because the total scores of TMIG-IC (maximum : 13 scores) were on average 12 for men and women. The average of steps/day was significantly correlated with stair-climbing, chair-rising and knee extensor strength in men and women, and with body weight, body mass index (BMI), percent body fat (%Fat) and leg extensor power in women. The BMI and %Fat levels were significantly lower while the handgrip strength and knee extensor strength were significantly higher in women who attained to the level of the pedometer-determined physical activity as recommended by the MHLW.The present study suggests that both men and women who take a lot of steps on a daily basis tend to demonstrate excellent leg strength and thus have a good ability to perform the tasks of daily living. In addition, the degree of obesity tends to be lower in women who regularly take a lot of steps. In addition, the number of daily steps taken has been recognized to be linked to gender, and such a link has also been suggested to be stronger in women than in men.

EFFECT OF INDIVIDUAL FEEDBACK INFORMATION IN A CORRESPONDECE COURSE TYPE WALKING PROGRAM BASED ON BEHAVIORAL SCIENCE / 体力科学

The purpose of this study was to investigate the effect of individual feedback intervention (IFB) or general video intervention (GV) on promoting daily physical activity. One hundred and thirty-six community-dwelling people volunteered as subjects and participated in the 2-month walking program provided as a correspondence course. The subjects were randomly allocated to one of four groups, which consisted of either IFB or GV. Each of the groups was based on behavioral science. The stage of change in exercise, self-efficacy for exercise and daily physical activity were measured before and after intervention 4 months later during the follow-up period. There were statistically significant effects of both ‘time’ (F=3.71, p=0.026) and ‘time’בIFB’ (F=3.76, p=0.025) in self-efficacy for exercise; while there was no significant effect of interaction between ‘time’בGV’. As for daily physical activity, there was no significant effect of the interaction both of ‘time’בIFB’ and ‘time’בGV’. These results suggest the IFB of promoting self-efficacy for exercise.