Abstract
BackgroundBest-practice early interventions to increase physical activity (PA) in children with overweight and obesity should be both feasible and evidence based. Walking is a basic human movement pattern that is practical, cost-effective, and does not require complex movement skills. However, there is still a need to investigate how much walking—as a proportion of total PA level—is performed by children who are overweight and obese in order to determine its utility as a public health strategy.ObjectiveThis study aimed to (1) investigate the proportion of overall PA indicators that are explained by step-based metrics and (2) study step accumulation patterns relative to achievement of public health recommendations in children who are overweight and obese.MethodsA total of 105 overweight and obese children (mean 10.1 years of age [SD 1.1]; 43 girls) wore hip-worn accelerometers for 7 days. PA volumes were derived using the daily average of counts per 15 seconds, categorized using standard cut points for light-moderate-vigorous PA (LMVPA) and moderate-to-vigorous PA (MVPA). Derived step-based metrics included volume (steps/day), time in cadence bands, and peak 1-minute, 30-minute, and 60-minute cadences.ResultsSteps per day explained 66%, 40%, and 74% of variance for counts per 15 seconds, LMVPA, and MVPA, respectively. The variance explained was increased up to 80%, 92%, and 77% by including specific cadence bands and peak cadences. Children meeting the World Health Organization recommendation of 60 minutes per day of MVPA spent less time at zero cadence and more time in cadence bands representing sporadic movement to brisk walking (ie, 20-119 steps/min) than their less-active peers.ConclusionsStep-based metrics, including steps per day and various cadence-based metrics, seem to capture a large proportion of PA for children who are overweight and obese. Given the availability of pedometers, step-based metrics could be useful in discriminating between those children who do or do not achieve MVPA recommendations.Trial RegistrationClinicalTrials.gov NCT02295072; https://clinicaltrials.gov/ct2/show/NCT02295072
Highlights
MethodsA total of 105 overweight and obese children (mean 10.1 years of age [SD 1.1]; 43 girls) wore hip-worn accelerometers for 7 days
MethodsDecreased physical activity (PA) is associated with increased risk of noncommunicable diseases [1,2,3] and is responsible for approximately 9% of premature mortality [4]
Given the availability of pedometers, step-based metrics could be useful in discriminating between those children who do or do not achieve moderate-to-vigorous PA (MVPA) recommendations
Summary
Decreased physical activity (PA) is associated with increased risk of noncommunicable diseases [1,2,3] and is responsible for approximately 9% of premature mortality [4]. Time-stamped accelerometers are capable of detecting step-based metrics, including a tally of step accumulation over the day (ie, volume [steps/day]), the time spent in incremental cadence bands (eg, time spent walking at 80-99 steps/min), and/or peak 1-minute, 30-minute, and 60-minute cadence indices (ie, average steps/min of the highest 1, 30, or 60 nonconsecutive minutes in a day, respectively) [18,19,20]. These metrics are referred to hereafter as step-based metrics. This study aimed to (1) investigate the proportion of overall PA that is explained by ambulatory activity (ie, step-based metrics) in children with overweight and obesity and (2) study step-based patterns relative to PA guidelines achievement in children with overweight and obesity
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