// Research review - Analysis of pedometer-bsed walking interventions and weight loss
by Dr Mike Climstein
Title: ‘A Meta-Analysis of Pedometer-based walking interventions and weight loss’
Authors: Dr’s Richardson, Newton et al., (Univ. of Michigan Medical School, USA).
Source: Annuals of Family Medicine 6 (1); pp69-77, 2008. Available for free download online at www.annfammed.org/cgi/reprint/6/1/69
I can’t tell you how many patients I have prescribed the use of a pedometer. Each patient is different of course, but they do all exhibit a number of similarities. Imagine seeing patients with varying chronic diseases, day-in and day-out, who at best are able to attend a health and fitness facility two to three days per week. Somewhere down the line of their priorities, after work and family commitments is their commitment to their own health. To meet the recommended guidelines, these patients should be completing regular physical activity most days of the week. Combined with their prescribed medications, this will afford them the best control of their various disease states.
Given the time restrictions of these patients, I believe pedometers offer a motivational strategy to measurably increase the amount of exercise they are completing each day/week. The purpose of this study by Dr Caroline Richardson and her colleagues was to complete a meta-analysis on research publications which investigated the effectiveness of pedometers on weight loss.
The authors reviewed research studies which had investigated pedometers since 1995; did not include any simultaneous dietary intervention; lasted at least four weeks; and featured subjects who were overweight or obese. Their search of refereed published literature included the databases of CINAHL, MEDLINE, PsycINFO, and SportDiscus. A total of 1,405 articles were found across all of the databases, with only nine meeting the authors’ inclusion criteria. Four of the nine studies were randomised control trials, while the others consisted of cohort investigations. Average baseline BMI’s ranged from 28.6 (overweight) to 35.0 (obesity Class 1) with the duration of the use of the pedometers ranging from eight to 52 weeks, the average being 16 weeks. The majority of all subjects were sedentary prior to participation in the studies.
The initial step counts (measured with pedometer) at the beginning of each study ranged from 4,700 to just over 7,000. The increase in pedometer step counts at the end of the studies ranged from 1,800 to 4,500 additional steps. More importantly, the weight loss associated with the pedometer programs ranged from 0.0kg to 3.7kg; the average weight loss for all of the studies was 1.27kg, which equated to a weight loss of 0.05kg per week for each participant.
The authors concluded that their results were consistent with previous studies and showed that the use of pedometers is associated with modest weight loss that is beneficial from a clinical perspective. Although the results found that subjects lost an average of only 0.05kg per week, this equated to a weight loss of approximately 0.5kg every 10 weeks and if continued over a period of 12 months could equate to a weight loss of 2 to 3 per cent of an individual’s body weight.
Of additional importance was the significant increase seen in daily step rates (i.e., 4,000/day) which the authors stated would result in health benefits independent of weight loss. These benefits include reduced risk of adverse cardiovascular events, improved blood pressure, and improved glycaemia in individuals with pre-diabetes or existing type II diabetes.
PROS: Good article which lends support to the use of pedometers for direct and indirect health benefits.
CONS: The studies reviewed had relatively high ‘pre-study’ pedometer step counts (i.e., 4,700 to 7,000). The patients I see and classify as sedentary tend to complete between only 2,000 and 3,000 steps per day, which is significantly lower. It would have been beneficial if the authors had provided specifics on the ‘rate of improvement’ used by each study for increased steps each week.
Dr Mike Climstein, PhD FASMF FACSM FAAESS DE
Dr Mike has an academic appointment with the School of Exercise Science, Australian Catholic University (NSW) and a clinical appointment as Director of Chronic Disease Rehabilitation at the Vale Medical Clinic, NSW. He is recognised as one of Australia’s leading clinical exercise physiologists working with patients suffering from a wide array of chronic diseases and disorders. For more information on any of the Research Reviews, please e-mail firstname.lastname@example.org
NETWORK • WINTER 2008 • P67