The effect of two different health messages on physical activity levels and health in sedentary overweight, middle-aged women

Physical Activity Interventions for Postnatal Weight Management: A Systematic Literature Review

Physical activity (PA) maintains weight and reduces postnatal weight retention (PWR), thereby lowering obesity-related comorbidities. There is only limited evidence on the most effective postnatal PA for Malaysian women. This review identified evidence-based literature on the effectiveness of PA interventions in managing weight in postnatal women and the preferred type of intervention for them. A systematic literature search was conducted following the preferred reporting items for systematic reviews and meta-analyses guidelines. Randomised controlled trials and quasi-experimental research related to PA interventions for women during the postnatal period (18 months after delivery) published in English from 2011 to 2021 were searched in ProQuest, Scopus, Springer Link and PubMed using the following keywords: 'physical activity', 'weight management' and 'postnatal women'. Intervention groups with weight and body mass index measured after any supervised PA guidance/counselling with a minimum follow-up of 10 weeks were included in the analysis. Those with pharmacological management and a comparator control group were excluded. A total of six articles met the inclusion criteria. Using the revised Cochrane risk of bias tool for randomised trials, one of these articles was classified as low-risk, two as having some concerns and three as having a high risk of bias. Walking, yoga and Pilates were found to be the most appropriate and preferred types of physical activity, despite having a small but significant impact on postnatal women's weight management. Healthcare professionals should adopt programmes that explicitly target these PA interventions to manage PWR.

Effect of Nordic Walking Training on Physical Fitness and Self-Assessment of Health of People with Chronic Non-Specific Lower Back Pain

In order to determine the impact of a four-week cycle of Nordic Walking (NW) training on the physical fitness of people with chronic non-specific lower back pain and the impact of this form of activity on their self-assessment of health quality, the study included 80 men and women aged 29 to 63 years. The subjects were divided into two equal (40-person) groups: experimental and control. In both study groups the degree of disability in daily activities caused by back pain was assessed with the FFb-H-R questionnaire, the physical fitness was evaluated with the modified Fullerton test and the sense of health quality was assessed with the SF-36 questionnaire. The same tests were repeated after four weeks. In the experimental group NW training was applied between the two studies. During four weeks, 10 training units were carried out, and each training session lasted 60 min with a two-day break between each training. The four-week NW training resulted in a statistically significant sense of disability due to back pain (p < 0.001), significant improvement of physical fitness expressed by improvement in upper (p < 0.001) and lower (p < 0.01) body strength, upper and lower body flexibility (p < 0.001) and ability to walk a longer distance in a 6-min walk test (p < 0.001). The training participants also showed significant improvements in health quality in both physical (p < 0.001) and mental (p < 0.001) components. The four-week NW training has a positive impact on the physical fitness of men and women with chronic lower back pain. Participation in NW training also contributes to a significant reduction in the sense of disability caused by back pain and improvement in the self-assessment of health quality.

Effects of Walking Exercise Program Based on Duration on the Body Composition and Lipid Profile in Overweight and Obesity Female College Students

The lack of physical activity is one factors that causes the increased prevalence of overweight and obesity in Indonesia. A walking exercise program is a simple strategy for weight loss and the prevention of various chronic diseases. This research aims to analyze the effects of walking exercise programs base on duration which involve an increased number of daily steps on the body's composition and lipid profile. The quasi-experimental design included 40 female university students aged 20–30, whose body mass index (BMI) was ≥25 kg/m2. They are divided into two groups: 60 minutes (WE-60) and 40 minutes (WE-40) walking program. All groups performed the program intervention five times per week, carried out for a total of 12 weeks, with a heart rate of 50%-75%. The results showed that an additional 60-minute walking exercise program led to a greater increase in the total daily steps (P<0.001), and it has a significant effect on weight (P=0.005), BMI (P=0.002), WC (P=0.003), visceral fat (P=0.001), fat mass (P=0.001) and the body fat percentage (P=0.007), compared to the 40 minutes walking group intervention. However, the lipid profiles of both groups were not significantly different. In conclusion, the addition of a 60-minute walking exercise program (WE-60) five times per week, improved the daily steps and significantly affected body composition, but it had no significant effect on the lipid profile.

Objectively determined physical activity and adiposity measures in adult women: A systematic review and meta-analysis

The prevalence of adiposity is increasing among adult women. Although emerging evidence suggest that all patterns of heightened physical activity (PA) are important to benefit adiposity, the relationship between objectively assessed intensities of PA and adiposity in women has not yet been assessed. Therefore, this systematic review and meta-analysis aims to qualitatively synthesize and quantitatively assess the evidence for any relationship between objectively measured PA and a wide range of adiposity indicators to guide PA prescription in adult women. Four databases (PubMed, Web of Science, Scopus, and the Cochrane library) were searched for eligible studies. 35 studies were included (25 observational and 10 interventional studies), with a total of 9,176 women from 20 countries included. The overall pooled correlation for random effects model (n = 1 intervention and n = 15 cross-sectional studies) revealed that the total volume of physical activity (TPA) was moderately associated with percentage body fat (%BF) (r = −0.59; 95% CI: −1.11, −0.24; p = 0.003). There was a weak but significant association between MVPA with body mass index (BMI), waist circumference (WC), and visceral adiposity. Daily steps were significantly associated with BMI, %BF, WC, and fat mass, with the strongest association with %BF (r = −0.41; 95% CI: −0.66, −0.19; p < 0.001). Walking programs resulting in increasing daily steps only had a significant effect on WC (SMD = −0.35; 95% CI: −0.65, −0.05; p = 0.02). Overall, objectively determined PA in terms of steps, TPA and MVPA were favorably associated with adiposity outcomes. The improvement in adiposity can be achieved by simply accumulating more PA than previously and adiposity is more likely to be benefited by PA performed at higher intensity. Nonetheless, these results should be interpreted with caution as there were a small number of studies included in the meta-analysis and the majority of studies included utilized cross-sectional designs.

Associations between Objectively Determined Physical Activity and Cardiometabolic Health in Adult Women: A Systematic Review and Meta-Analysis

The purpose of this systematic review and meta-analysis was to qualitatively synthesize and quantitatively assess the evidence of the relationship between objectively determined volumes of physical activity (PA) and cardiometabolic health in women. Four databases (PubMed, Web of Science, Scopus, and the Cochrane library) were searched and, finally, 24 eligible studies were included, with a total of 2105 women from eight countries. A correlational meta-analysis shows that moderate-to-vigorous intensity physical activity (MVPA) was favorably associated with high-density lipoprotein (r = 0.16; 95% CI: 0.06, 0.25; p = 0.002); however, there was limited evidence for the effects of most of the other cardiometabolic biomarkers recorded from steps, total physical activity, light- and moderate-intensity physical activity and MVPA. It is most compelling and consistent that being more physically active is beneficial to the metabolic syndrome. Overall, PA levels are low in adult women, suggesting that increasing the total volume of PA is more important than emphasizing the intensity and duration of PA. The findings also indicate that, according to the confounding effects of body composition and cardiorespiratory fitness, meeting the minimal level of 150 min of moderate-intensity physical activity recommended is not enough to obtain a significant improvement in cardiometabolic indicators. Nonetheless, the high heterogeneity between studies inhibits robust conclusions.

Walking for hypertension

BACKGROUND

Increased physical activity has been recommended as an important lifestyle modification for the prevention and control of hypertension. Walking is a low-cost form of physical activity and one which most people can do. Studies testing the effect of walking on blood pressure have revealed inconsistent findings.

OBJECTIVES

To determine the effect of walking as a physical activity intervention on blood pressure and heart rate.

SEARCH METHODS

We searched the following databases up to March 2020: the Cochrane Hypertension Specialised Register, CENTRAL (2020, Issue 2), Ovid MEDLINE, Ovid Embase, CINAHL, PsycINFO, SPORTDiscus, PEDro, the WHO International Clinical Trials Registry Platform, and ClinicalTrials.gov. We also searched the following Chinese databases up to May 2020: Index to Taiwan Periodical Literature System; National Digital Library of Theses and Dissertation in Taiwan; China National Knowledge Infrastructure (CNKI) Journals, Theses & Dissertations; and Wanfang Medical Online. We contacted authors of relevant papers regarding further published and unpublished work. The searches had no language restrictions.

SELECTION CRITERIA

Randomised controlled trials of participants, aged 16 years and over, which evaluated the effects of a walking intervention compared to non-intervention control on blood pressure and heart rate were included.

DATA COLLECTION AND ANALYSIS

We used standard methodological procedures expected by Cochrane. Where data were not available in the published reports, we contacted authors. Pooled results for blood pressure and heart rate were presented as mean differences (MDs) between groups with 95% confidence intervals (CIs). We undertook subgroup analyses for age and sex. We undertook sensitivity analyses to assess the effect of sample size on our findings.

MAIN RESULTS

A total of 73 trials met our inclusion criteria. These 73 trials included 5763 participants and were undertaken in 22 countries. Participants were aged from 16 to 84 years and there were approximately 1.5 times as many females as males. The characteristics of walking interventions in the included studies were as follows: the majority of walking interventions was at home/community (n = 50) but supervised (n = 36 out of 47 reported the information of supervision); the average intervention length was 15 weeks, average walking time per week was 153 minutes and the majority of walking intensity was moderate. Many studies were at risk of selection bias and performance bias. Primary outcome We found moderate-certainty evidence suggesting that walking reduces systolic blood pressure (SBP) (MD -4.11 mmHg, 95% CI -5.22 to -3.01; 73 studies, n = 5060). We found moderate-certainty evidence suggesting that walking reduces SBP in participants aged 40 years and under (MD -4.41 mmHg, 95% CI -6.17 to -2.65; 14 studies, n = 491), and low-certainty evidence that walking reduces SBP in participants aged 41 to 60 years (MD -3.79 mmHg, 95% CI -5.64 to -1.94, P < 0.001; 35 studies, n = 1959), and those aged 60 years of over (MD -4.30 mmHg, 95% CI -6.17 to -2.44, 24 studies, n = 2610). We also found low certainty-evidence suggesting that walking reduces SBP in both females (MD -5.65 mmHg, 95% CI -7.89 to -3.41; 22 studies, n = 1149) and males (MD -4.64 mmHg, 95% CI -8.69 to -0.59; 6 studies, n = 203). Secondary outcomes We found low-certainty evidence suggesting that walking reduces diastolic blood pressure (DBP) (MD -1.79 mmHg, 95% CI -2.51 to -1.07; 69 studies, n = 4711) and heart rate (MD -2.76 beats per minute (bpm), 95% CI -4.57 to -0.95; 26 studies, n = 1747). We found moderate-certainty evidence suggesting that walking reduces DBP for participants aged 40 years and under (MD -3.01 mmHg, 95% CI -4.44 to -1.58; 14 studies, n = 491) and low-certainty evidence suggesting that walking reduces DBP for participants aged 41 to 60 years (MD -1.74 mmHg, 95% CI -2.95 to -0.52; 32 studies, n = 1730) and those aged 60 years and over (MD -1.33 mmHg, 95% CI -2.40 to -0.26; 23 studies, n = 2490). We found moderate-certainty evidence that suggests walking reduces DBP for males (MD -2.54 mmHg, 95% CI -4.84 to -0.24; 6 studies, n = 203) and low-certainty evidence that walking reduces DBP for females (MD -2.69 mmHg, 95% CI -4.16 to -1.23; 20 studies, n = 1000). Only 21 included studies reported adverse events. Of these 21 studies, 16 reported no adverse events, the remaining five studies reported eight adverse events, with knee injury being reported five times.

AUTHORS' CONCLUSIONS

Moderate-certainty evidence suggests that walking probably reduces SBP. Moderate- or low-certainty evidence suggests that walking may reduce SBP for all ages and both sexes. Low-certainty evidence suggests that walking may reduce DBP and heart rate. Moderate- and low-certainty evidence suggests walking may reduce DBP and heart rate for all ages and both sexes.

The Longitudinal Relationship Between Physical Activity and Joint Space Narrowing: 48-Month Follow-Up Data from the Osteoarthritis Initiative

OBJECTIVE

To determine whether amount of physical activity (PA) is a determinant of joint space narrowing (JSN) worsening over 48-months in participants with knee osteoarthritis (OA).

METHODS

Data were obtained from the Osteoarthritis Initiative. PA, measured using the Physical Activity Scale for the Elderly (PASE), was defined as the mean value of the annual measurements conducted prior to development of worsening JSN. Worsening JSN was defined as at least a partial grade increase in OARSI JSN score over 48 months, in comparison with baseline. Restricted cubic spline (RCS) function was used to group participants based on the linear association between PA and JSN worsening. A pooled logistic regression model was used to evaluate the association between PA and JSN worsening adjusted for confounders.

RESULTS

2,167 participants were included. In total, 625 (28.8%) participants had JSN worsening over 48 months. Compared with PASE score of 140-180, PASE scores of 100-140 and >220 associated with an increased risk of JSN worsening in men with OR (95% CI) of 1.73 (1.07, 2.81) and 1.83 (1.14, 2.93) respectively. Similarly, in participants with Kellgren and Lawrence grade 2, compared with a PASE score of 140-180, PASE score of <100 and >220 were associated with increased risks of JSN worsening, with OR (95% CIs) of 1.69 (1.13, 2.54) and 1.64 (1.05, 2.56) respectively.

CONCLUSION

Compared to moderate PA, higher or lower amounts of PA are associated with elevated risk for JSN worsening in men and in participants with KL grade 2 knees.

The effects of step-count monitoring interventions on physical activity: systematic review and meta-analysis of community-based randomised controlled trials in adults

Background

Step-count monitors (pedometers, body-worn trackers and smartphone applications) can increase walking, helping to tackle physical inactivity. We aimed to assess the effect of step-count monitors on physical activity (PA) in randomised controlled trials (RCTs) amongst community-dwelling adults; including longer-term effects, differences between step-count monitors, and between intervention components.

Methods

Systematic literature searches in seven databases identified RCTs in healthy adults, or those at risk of disease, published between January 2000–April 2020. Two reviewers independently selected studies, extracted data and assessed risk of bias. Outcome was mean differences (MD) with 95% confidence intervals (CI) in steps at follow-up between treatment and control groups. Our preferred outcome measure was from studies with follow-up steps adjusted for baseline steps (change studies); but we also included studies reporting follow-up differences only (end-point studies). Multivariate-meta-analysis used random-effect estimates at different time-points for change studies only. Meta-regression compared effects of different step-count monitors and intervention components amongst all studies at ≤4 months.

Results

Of 12,491 records identified, 70 RCTs (at generally low risk of bias) were included, with 57 trials (16,355 participants) included in meta-analyses: 32 provided change from baseline data; 25 provided end-point only. Multivariate meta-analysis of the 32 change studies demonstrated step-counts favoured intervention groups: MD of 1126 steps/day 95%CI [787, 1466] at ≤4 months, 1050 steps/day [602, 1498] at 6 months, 464 steps/day [301, 626] at 1 year, 121 steps/day [− 64, 306] at 2 years and 434 steps/day [191, 676] at 3–4 years. Meta-regression of the 57 trials at ≤4 months demonstrated in mutually-adjusted analyses that: end-point were similar to change studies (+ 257 steps/day [− 417, 931]); body-worn trackers/smartphone applications were less effective than pedometers (− 834 steps/day [− 1542, − 126]); and interventions providing additional counselling/incentives were not better than those without (− 812 steps/day [− 1503, − 122]).

Conclusions

Step-count monitoring leads to short and long-term step-count increases, with no evidence that either body-worn trackers/smartphone applications, or additional counselling/incentives offer further benefit over simpler pedometer-based interventions. Simple step-count monitoring interventions should be prioritised to address the public health physical inactivity challenge.

Systematic review registration

PROSPERO number CRD42017075810.

Physical deterioration and adaptive recovery in physically inactive breast cancer patients during adjuvant chemotherapy: a randomised controlled trial

Cardiorespiratory fitness is an independent risk factor for cardiovascular disease and shortened life expectancy in breast cancer survivors. This randomised controlled trial (n = 153) was designed for patients with a physically inactive lifestyle prediagnosis and concurrently referred to adjuvant chemotherapy. We compared two 12-week exercise interventions aimed at physiological and patient-reported outcomes (cardiorespiratory fitness, muscle strength, metabolic markers, physical activity, pain, fatigue), including a 39-week follow-up. A supervised hospital-based moderate to high intensity group exercise intervention was compared to an instructed home-based individual pedometer intervention. The two 12-week interventions included oncologists’ recommendations and systematic health counselling. Outcomes were measured at baseline and week 6, 12 and 39. Primary outcome cardiorespiratory fitness declined significantly during chemotherapy and was restored in both interventions at follow-up. The interventions effectively engaged breast cancer patients in sustaining physical activities during and following adjuvant treatment. A composite metabolic score improved significantly. Positive cardiorespiratory fitness responders had improved clinical effects on fatigue, pain and dyspnoea versus negative responders. We conclude that a loss of cardiorespiratory fitness among physically inactive breast cancer patients may be restored by early initiated interventions and by adapting to physical activity recommendations, leading to a decreased cardiovascular risk profile in breast cancer survivors.

Get the message? A scoping review of physical activity messaging

BACKGROUND

Understanding how to create and deliver effective physical activity (PA) messages for and to various population subgroups may play a role in increasing population PA levels. This scoping review aimed to provide an overview of what is known about PA messaging and highlight key research gaps.

METHODS

We followed a 5-stage protocol proposed by Arksey & O'Malley and the Preferred Reporting Items For Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews checklist. Stage 1: research questions were identified. Stage 2: we identified relevant studies by searching electronic databases, contacting existing networks and hand searching reference lists. Stage 3: studies were screened in Covidence™ software. Stage 4: study data were extracted and charted. Stage 5: findings from included studies were collated, summarised and reported in two ways: (1) a descriptive numerical analysis providing insight into extent, nature and distribution of the included studies, and (2) a narrative summary summarizing the evidence reviewed organised by messaging concepts and by population subgroup.

RESULTS

A total of 9525 references were imported into Covidence™ for screening. Of these, 123 studies were included in final analysis. We found that PA messaging evidence is complex and multidimensional in nature, with numerous concepts to consider when creating or evaluating messages. The extent to which these different PA messaging concepts have been researched is variable. Where research has accumulated and evidence is consistent, it supports the following: (1) PA messages should be framed positively and highlight short-term outcomes specifically relating to social and mental health, (2) message content should be tailored or targeted to intended recipient(s), and (3) when developing messages, formative research, psychological theory and/or social marketing principles should be used.

CONCLUSION

While it is unlikely to address global inactivity on its own, PA messaging may play a valuable role improving population PA levels. However, it is a complex and multidimensional concept and greater understanding is still needed. We present a synthesis of the existing evidence, highlighting key areas where evidence has accumulated and where gaps lie, as well as recommendations for PA messaging to different population subgroups.

Does having a pet influence the physical activity of their young female owners?

Background

Many studies have shown that having a dog has an impact on the increase in physical activity (PA) of people. However, what is often not taken into account in many such studies is owning of other pets. The aim of this study was to compare PA levels between animal owners and non-owners and to research potential differences between owners of different kinds of animals.

Method

111 young females of mean age 21 ± 1.2 years enrolled in this cross-sectional study. Czech version of short International physical activity questionnaire (IPAQ) was used to assess PA level, supplemented with a question about whether they owned an animal and what kind.

Results

People who owned a pet had higher frequency and duration of moderate physical activity (MPA) and spent more MET/min/wk. (p < 0.05). This difference has projected into total PA duration and also into calories burned in a week. Furthermore, a statistically significant difference between subgroups of animal owners was also confirmed for MPA and total PA in favour of horse owners.

Conclusions

Animal owners generally reported higher PA levels compared to people who do not own any pets. However, similarly significant in this particular age group was the kind of animal these young women owned.

Is the goal of 12,000 steps per day sufficient for improving body composition and metabolic syndrome? The necessity of combining exercise intensity: a randomized controlled trial

Background

To investigate the differences in body composition and metabolic syndrome (MS) under a daily 12,000-step strategy with or without moderate-intensity walking exercise in college students with obesity.

Methods

Thirty-two adults with obesity (mean (s.d.) age: 19.72 (0.80) years; height: 165.38 (3.99) cm; wt: 83.31 (4.66) kg; body mass index: 30.38 (0.83) kg m^− 2) were recruited and randomly assigned to the walking step goal group (WSG; achieving 12,000 steps per day), walking exercise group (WEG; achieving 12,000 steps per day, including 3 days per week on which walking at a step rate of over 103 steps min^− 1 was required), or control group (CG; maintaining a free-living life style). Each participant’s accumulated daily steps from daily activities and walking exercises were monitored using a smartwatch for 8 weeks. The variables of body composition and MS were measured before and after intervention.

Results

Average daily steps over 8 weeks did not significantly differ between the WSG and WEG (11,677.67 (480.24) vs. 12,131.90 (527.14) steps per day, respectively, P > .05). Although the CG and WSG showed no improvement in body composition, the WEG exhibited significant improvements in terms of hip circumference and visceral fat area (VFA) (∆ − 2.28 (3.27) cm and ∆ − 13.11 (9.83) cm², respectively, P < .05); high-density lipoprotein cholesterol (HDL-C), fasting glucose (FG), and triglycerides (TG) (∆ 16.36 (8.39), ∆ − 2.53 (3.73), and ∆ − 10.52 (36.26) mg dL^− 1, respectively, P < .05). The WSG exhibited improvements only in HDL-C (∆ 14.24 (16.13) mg dL^− 1, P < .05).

Conclusion

The combination of walking exercise program and daily step goal is a more time efficient strategy in improving body composition and MS than simply establishing a daily step goal. Furthermore, this strategy may also include a potential reduction effect on the risk factors of cardiovascular diseases.

Trial registration

Australian New Zealand Clinical Trials Registry, number ACTRN12618001237279 (Retrospectively registered).

Activity monitoring using a mHealth device and correlations with psychopathology in patients with chronic schizophrenia

There are few studies of mobile-Health (mHealth) device application with schizophrenic patients. We aimed to quantitatively assess patient's activity and the relationship between their physical activity and the severity of their psychopathologies. Then we attempted to identify the patients who required intervention and evaluated the feasibility of using the mHealth device. A total of 61 of the 76 available hospitalized patients with chronic schizophrenia who participated in the activity programs were enrolled. They wore a mHealth device for a week to assess their activity (steps/day). The Positive and Negative Syndrome Scale (PANSS) was completed by the subjects. As a result, the positive subscale of the PANSS and the positive and negative factors of the PANSS 5-factor structure showed a predictive value for low levels of physical activity. The group of subjects with a high total PANSS score had a significantly lower level of physical activity than the other groups. In conclusion, physical activity showed a significant association with positive symptoms as well as negative symptoms. The mHealth device showed relatively good feasibility for schizophrenic patients. We should pay more attention to the activity of patients with high PANSS scores.

Predicting Physical Activity-Related Outcomes in Overweight and Obese Adults: A Health Action Process Approach

BACKGROUND

We tested the adequacy of a model based on the Health Action Process Approach (HAPA) in predicting changes in psychological, body composition, and cardiovascular risk outcomes with respect to physical activity participation in overweight and obese adults.

METHODS

Measures of HAPA constructs (action and maintenance self-efficacy, outcome expectancies, action planning, risk perceptions, intentions, behaviour), psychological outcomes (quality of life, depression, anxiety, stress symptoms), body composition variables (body weight, body fat mass), cardiovascular risk measures (total cholesterol, low density lipoprotein), and self-reported physical activity behaviour were administered to participants (N = 74) at baseline, and 6 and 12 weeks later.

RESULTS

Data were analysed using variance-based structural equation modelling with residualised change scores for HAPA variables. The model revealed effects of action self-efficacy and outcome expectancies on physical activity intentions, action self-efficacy on maintenance self-efficacy, and maintenance self-efficacy and intentions on action planning. Intention predicted psychological and body composition outcomes indirectly through physical activity behaviour. Action planning was a direct predictor of psychological, cardiovascular, and body composition outcomes.

CONCLUSIONS

Data supported HAPA hypotheses in relation to intentions and behaviour, but not the role of action planning as a mediator of the intention-behaviour relationship. Action planning predicted outcomes independent of intentions and behaviour.

Do activity monitors increase physical activity in adults with overweight or obesity? A systematic review and meta-analysis

OBJECTIVE

To systematically assess contemporary knowledge regarding behavioral physical activity interventions including an activity monitor (BPAI+) in adults with overweight or obesity.

METHODS

PubMed/MEDLINE, Embase, CINAHL, PsycINFO, CENTRAL, and PEDro were searched for eligible full-text articles up to 1 July 2015. Studies eligible for inclusion were (randomized) controlled trials describing physical activity outcomes in adults with overweight or obesity. Methodological quality was independently assessed employing the Cochrane Collaboration's tool for risk of bias.

RESULTS

Fourteen studies (1,157 participants) were included for systematic review and 11 for meta-analysis. A positive trend in BPAI+ effects on several measures of physical activity was ascertained compared with both wait list or usual care and behavioral physical activity interventions without an activity monitor (BPAI-). No convincing evidence of BPAI+ effectiveness on weight loss was found compared with BPAI-.

CONCLUSIONS

Behavioral physical activity interventions with an activity monitor increase physical activity in adults with overweight or obesity. Also, adding an activity monitor to behavioral physical activity interventions appears to increase the effect on physical activity, although current evidence has not yet provided conclusive evidence for its effectiveness.

Using new technologies to promote weight management: a randomised controlled trial study protocol

Background

Over the last three decades, overweight and obesity and the associated health consequences have become global public health priorities. Methods that have been tried to address this problem have not had the desired impact, suggesting that other approaches need to be considered. One of the lessons learned throughout these attempts is that permanent weight loss requires sustained dietary and lifestyle changes, yet adherence to weight management programs has often been noted as one of the biggest challenges. This trial aims to address this issue by examining whether social media, as a potential health promotion tool, will improve adherence to a weight management program. To test the effectiveness of this measure, the designated program will be delivered via the popular social networking site Facebook, and compared to a standard delivery method that provides exactly the same content but which is communicated through a pamphlet. The trial will be conducted over a period of twelve weeks, with a twelve week follow-up. Although weight loss is expected, this study will specifically investigate the effectiveness of social media as a program delivery method. The program utilised will be one that has already been proven to achieve weight loss, namely The CSIRO Total Wellbeing Diet.

Methods/design

This project will be conducted as a 3-arm randomised controlled trial. One hundred and twenty participants will be recruited from the Perth community, and will be randomly assigned to one of the following three groups: the Facebook group, the pamphlet group, or a control group. The Facebook Group will receive the weight management program delivered via a closed group in Facebook, the Pamphlet Group will be given the same weight management program presented in a booklet, and the Control Group will follow the Australian Dietary Guidelines and the National Physical Activity Guidelines for Adults as usual care. Change in weight, body composition and waist circumference will be initial indicators of adherence to the program. Secondary outcome measures will be blood glucose, insulin, blood pressure, arterial stiffness, physical activity, eating behaviour, mental well-being (stress, anxiety, and depression), social support, self-control, self-efficacy, Facebook activity, and program evaluation.

Discussion

It is expected that this trial will support the use of social media - a source of social support and information sharing - as a delivery method for weight management programs, enhancing the reduction in weight expected from dietary and physical activity changes. Facebook is a popular, easy to access and cost-effective online platform that can be used to assist the formation of social groups, and could be translated into health promotion practice relatively easily. It is anticipated in the context of the predicted findings that social media will provide an invaluable resource for health professionals and patients alike.

Trial registration

Australian New Zealand Clinical Trials Register (ANZCTR): ACTRN12614000536662. Date registered: 21 May 2014.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-015-1849-4) contains supplementary material, which is available to authorized users.

Postmenopausal obesity: 12,500 steps per day as a remedy? Relationships between body composition and daily steps in postmenopausal women

INTRODUCTION

To verify relationships between physical activity (steps per day) and obesity (components of body composition) among postmenopausal women.

MATERIAL AND METHODS

Physical activity (ActiGraph GT1M accelerometer; worn for 7 days) and obesity (body composition analyzer InBody 720) were assessed among 79 healthy postmenopausal women (age 63.25 ± 5.51 years; range: 51-81 years). In order to determine differences in body composition in women with different levels of physical activity, one-way analysis of covariance (ANCOVA) was conducted, with age of participants as a covariate.

RESULTS

Significant intergroup differences in almost all analyzed components of the body composition (weight, body mass index, waist-hip ratio, visceral fat area, body fat mass and percent of body fat) were obtained. Highly active women (≥ 12,500 steps/day) had lower weight and adiposity parameters than those that represented low (< 7,500 steps/day) or somewhat active (7,500-9,999 steps/day) groups. Besides, a noteworthy difference between active (10,000-12,499 steps/day) and low active women was recorded. Noticeably, only in the most active group was the BMI within normal ranges.

CONCLUSIONS

The higher physical activity, the lower obesity in postmenopausal women. The recommended 10,000 steps/day seems insufficient for this age group. Based on the obtained results, postmenopausal women should walk at least 12,500 steps per day to improve their health.

Compliance to step count and vegetable serve recommendations mediates weight gain prevention in mid-age, premenopausal women. Findings of the 40-Something RCT

The 40-Something RCT aimed to determine if a 12-month health professional-led intervention could modify diet and physical activity behaviour for obesity prevention, in 44-50 year old, non-obese (BMI = 18.5-29.9 kg/m(2)) premenopausal women. Women were monitored for an additional 12 months to determine if effects could be maintained. This paper aimed to explore dietary and physical activity behavioural mediators hypothesised to be causally associated with weight change. Fifty-four women were randomised to a Motivational Interviewing Intervention (MI) (n = 28; five health professional consultations) or a Self-Directed Intervention (n = 26; written advice). Compliance to 10 study recommendations was measured at three months by a four-day weighed food and physical activity record including pedometer-measured step counts, self-reported exercise minutes and sitting time. The 10 compliance scores were independently assessed in mediation models for 12- and 24-month weight change. The MI effect on step count was an increase of 0.99 points on the 10-point compliance scale (p ≤ 0.01). This MI effect on step count significantly mediated the 12 and 24 month effect on weight (12 months AB = -0.74, 95%CI = -1.95, -0.14; 24 months AB = -1.06, 95% CI = -2.56, -0.36), accounting for 37.23% and 53.79% of the effect, respectively. The MI effect on vegetable serves was an increase of 1.50 points on the compliance scale (p = 0.02). The MI effect on vegetable compliance significantly mediated the effect on weight at 24 months (AB = -0.54, 95% CI = -1.50, -0.04), accounting for 24.92% of the effect. The remaining eight dietary and physical activity compliance scores did not significantly mediate weight loss. Encouraging women to take 10,000 steps and eat five vegetable serves per day may be a promising strategy to achieve long-term weight control at mid-life.

Changes in physical activity in healthy people and COPD patients

PURPOSE

Pedometry is an objective method to analyse part of physical activity. The aims of this study were to evaluate physical activity (by quantifying walking steps/day) in Romanian chronic obstructive pulmonary disease (COPD) patients and healthy subjects.

METHODS

A total of 58 COPD patients (GOLD stages III and IV) and 273 healthy subjects, divided by decades of age, wore pedometers for 2 weeks.

RESULTS

Significant decrease of physical activity level was observed in COPD patients vs. control group (3,414 ± 1,105 vs. 7,200 ± 2,452 steps/day). Walking performance of patients with COPD stage III was better than that of patients with COPD stage IV. For both groups, the lowest activity level was recorded during the weekend. Patients with COPD could not perform any aerobic movement.

CONCLUSIONS

This study revealed a difference of physical activity in both healthy individuals and COPD patients, in the latter group the decrease being worse and in accordance with the disease severity.

Walking to meet physical activity guidelines in knee osteoarthritis: is 10,000 steps enough?

OBJECTIVE

To study if step goals (eg, walking 10,000 steps a day) approximate meeting the 2008 Physical Activity Guidelines for Americans.

DESIGN

Cross-sectional observational cohort.

SETTING

Community.

PARTICIPANTS

People with or at high risk of knee OA (N=1788).

INTERVENTIONS

None.

MAIN OUTCOME MEASURES

Objective physical activity data were collected over 7 consecutive days from people with or at high risk of knee OA participating in the Multicenter Osteoarthritis Study. Using activity monitor data, we determined the proportion that (1) walked ≥10,000 steps per day, (2) met the 2008 Physical Activity Guidelines, and (3) achieved both recommendations.

RESULTS

Of the subjects studied (mean age ± SD, 67±8y; mean body mass index ± SD, 31±6kg/m(2); 60% women), 16.7% of men and 12.6% of women walked ≥10,000 steps per day, while 6% of men and 5% of women met the 2008 Physical Activity Guidelines for Americans. Of those walking ≥10,000 steps per day, 16.7% and 26.7% of men and women, respectively, also met the 2008 Physical Activity Guidelines.

CONCLUSIONS

Among this sample of older adults with or at high risk of knee OA, walking ≥10,000 steps a day did not translate into meeting public health guidelines. These findings highlight the disparity between the number of steps believed to be needed per day and the recommended time-intensity guidelines to achieve positive health benefits.

Advantage of distance- versus time-based estimates of walking in predicting adiposity

PURPOSE

Physical activity recommendations are defined in terms of time spent being physically active (e.g., 30 min of brisk walking, 5 d · wk(-1)). However, walking volume may be more naturally assessed by distance than by time. Analyses were therefore performed to test whether time or distance provides the best metric for relating walking volume to estimated total and regional adiposity.

METHODS

Linear and logistic regression analyses were used to relate exercise dose to body mass index (BMI), body circumferences, and obesity in a cross-sectional sample of 12,384 female and 3434 male walkers who reported both usual distance walked and time spent walking per week on survey questionnaires. Metabolic equivalent hours per day (MET · h · d(-1), 1 MET = 3.5 mL O2 · kg(-1) · min(-1)) were calculated from the time and pace, or distance and pace, using published compendium values.

RESULTS

Average MET-hours per day walked was 37% greater when calculated from time spent walking versus usual distance in women and was 32% greater in men. Per MET-hours per day, declines in BMI and circumferences (slope ± SE) were nearly twice as great, or greater, for distance- versus time-derived estimates for kilograms per squared meter of BMI (females = -0.58 ± 0.03 vs -0.31 ± 0.02, males = -0.35 ± 0.04 vs -0.15 ± 0.02), centimeter of waist circumference (females = -1.42 ± 0.07 vs -0.72 ± 0.04, males = -0.96 ± 0.10 vs -0.45 ± 0.07), and reductions in the odds for total obesity (odds ratio: females = 0.72 vs 0.84, males = 0.84 vs 0.92) and abdominal obesity (females = 0.74 vs 0.85, males = 0.79 vs 0.91, all comparisons significant).

CONCLUSIONS

Distance walked may provide a better metric of walking volume for epidemiologic obesity research, and better public health targets for weight control, than walking duration. Additional research is required to determine whether these results, derived in a sample that regularly walks for exercise, apply more generally.

Can we teach moderate intensity activity? Adult perception of moderate intensity walking

OBJECTIVES

To investigate how people determine the intensity of their physical activity, respond to instruction, and their understanding of moderate intensity walking.

DESIGN

Experimental.

METHODS

Forty nine regular walkers had their walking speed, heart rate and rate of perceived exertion measured during their normal walking behaviour, when instructed to walk at a moderate intensity, and after provision of feedback on how to meet moderate intensity walking.

RESULTS

Although moderate intensity walking was generally perceived as too low to be beneficial, walking speed was the best variable matched across all experiments for moderate intensity (83.7%, 67.3% and 93.9%), followed by heart rate, with a large proportion of participants responding favourably to instruction relating to heart rate and speed to meet moderate intensity walking. Rate of perceived exertion was a poor reflector of walking intensity.

CONCLUSION

Most participants naturally selected a walking intensity that elicits moderate intensity and when instructed to walk at moderate intensity, the intensity is more vigorous. Attempting to match speed and heart rate limits for moderate intensity reduced the intensity perceived by participants.

Promoting walking among older adults living in retirement communities

The authors tested the feasibility and acceptability, and explored the outcomes, of 2 walking interventions based on ecological models among older adults living in retirement communities. An enhanced intervention (EI) was compared with a standard walking intervention (SI) among residents in 4 retirement facilities (N = 87 at baseline; mean age = 84.1 yr). All participants received a walking intervention including pedometers, printed materials, and biweekly group sessions. EI participants also received phone counseling and environmental-awareness components. Measures included pedometer step counts, activities of daily living, environment-related variables, physical function, depression, cognitive function, satisfaction, and adherence. Results indicated improvements among the total sample for step counts, neighborhood barriers, cognitive function, and satisfaction with walking opportunities. Satisfaction and adherence were high. Both walking interventions were feasible to implement among facility-dwelling older adults. Future studies can build on this multilevel approach.

Effect of physical activity intervention based on a pedometer on physical activity level and anthropometric measures after childbirth: a randomized controlled trial

BACKGROUND

Pregnancy and childbirth are associated with weight gain in women, and retention of weight gained during pregnancy can lead to obesity in later life. Diet and physical activity are factors that can influence the loss of retained pregnancy weight after birth. Exercise guidelines exist for pregnancy, but recommendations for exercise after childbirth are virtually nonexistent. The aim of this study was to evaluate the effect of physical activity intervention based on pedometer on physical activity level and anthropometric measures of women after childbirth.

METHODS

We conducted a randomized controlled trial in which 66 women who had given birth 6 weeks to 6 months prior were randomly assigned to receive either a 12 week tailored program encouraging increased walking using a pedometer (intervention group, n = 32) or routine postpartum care (control group, n = 34). During the 12-week study period, each woman in the intervention group wore a pedometer and recorded her daily step count. The women were advised to increase their steps by 500 per week until they achieved the first target of 5000 steps per day and then continued to increase it to minimum of 10,000 steps per day by the end of 12th week. Assessed outcomes included anthropometric measures, physical activity level, and energy expenditure per week. Data were analyzed using the paired t-test, independent t-test, Mann-Whitney, chi-square, Wilcoxon, covariance analysis, and the general linear model repeated measures procedure as appropriate.

RESULTS

After 12 weeks, women in the intervention group had significantly increased their physical activity and energy expenditure per week (4394 vs. 1651 calorie, p < 0.001). Significant differences between-group in weight (P = 0.001), Body Mass Index (P = 0.001), waist circumference (P = 0.001), hip circumference (P = 0.032) and waist-hip ratio (P = 0.02) were presented after the intervention. The intervention group significantly increased their mean daily step count over the study period (from 3249 before, to 9960 after the intervention, p < 0.001).

CONCLUSION

A physical activity intervention based on pedometer is an effective means to increase physical activity; reducing retention of weight gained during pregnancy and can improve anthropometric measures in postpartum women.

TRIAL REGISTRATION

ISRCTN: IRCT201105026362N1.