Effects of a 6-Month Walking Study on Blood Pressure and Cardiorespiratory Fitness in U.S. and Swedish Adults: ASUKI Step Study

Accumulated Short Bouts of Walking in Older Adults With Type 2 Diabetes: Effects on Glycosylated Hemoglobin (HbA1c) and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR)

The current study examined the effects of accumulated short bouts of walking on glycosylated hemoglobin (HbA1c) and homeostasis model assessment of insulin resistance (HOMA-IR) of older adults with type 2 diabetes. Differences in variables between models of accumulated bouts of walking and 10,000 steps were also investigated. Sedentary participants (N = 38) were randomized into one of three groups: accumulated 10-minute bouts of walking at 100 steps/min (10/100MW), accumulated 10,000 steps (10KS), or control. HbA1c, HOMA-IR, blood lipids, and cardiorespiratory fitness (VO2max) were assessed before and after the intervention. VO2max, HbA1c, and HOMA-IR in the 10/100MW and 10KS groups showed significant and comparable improvements postintervention compared to preintervention (p < 0.05). Furthermore, the change in average daily step count was significantly associated with the change in HbA1c of the two walking groups (r = -0.61 for 10KS and r = -0.63 for 10/100MW; p < 0.05). Accumulated short bouts of walking at 100 steps/min and 10,000 steps daily improved HbA1c and HOMA-IR of older adults with type 2 diabetes. [Research in Gerontological Nursing, 16(5), 250-258.].

Automatic Generation of Urban Road 3D Models for Pedestrian Studies from LiDAR Data

The point clouds acquired with a mobile LiDAR scanner (MLS) have high density and accuracy, which allows one to identify different elements of the road in them, as can be found in many scientific references, especially in the last decade. This study presents a methodology to characterize the urban space available for walking, by segmenting point clouds from data acquired with MLS and automatically generating impedance surfaces to be used in pedestrian accessibility studies. Common problems in the automatic segmentation of the LiDAR point cloud were corrected, achieving a very accurate segmentation of the points belonging to the ground. In addition, problems caused by occlusions caused mainly by parked vehicles and that prevent the availability of LiDAR points in spaces normally intended for pedestrian circulation, such as sidewalks, were solved in the proposed methodology. The innovation of this method lies, therefore, in the high definition of the generated 3D model of the pedestrian space to model pedestrian mobility, which allowed us to apply it in the search for shorter and safer pedestrian paths between the homes and schools of students in urban areas within the Big-Geomove project. Both the developed algorithms and the LiDAR data used are freely licensed for their use in further research.

The association between self-perceived walking pace with the incidence of hypertension: the 'Seguimiento Universidad de Navarra' cohort

OBJECTIVE

Although available evidence supports the protective effects of walking on hypertension - a major risk factor for cardiovascular disease and stroke - more information is needed in determining whether walking pace independently provides additional hypertension risk reductions. This prospective study determined the association between self-reported walking pace and the incidence of hypertension in the 'Seguimiento Universidad de Navarra' (SUN) cohort in Spain.

METHODS

Our population sample consisted of 15 357 university graduates initially free of chronic disease or hypertension. During an average follow-up time of 10.9 years, 1673 incident cases of hypertension were observed. Hazard ratios and 95% confidence intervals (95% CIs) for hypertension risk of each walking pace [slow (reference), normal, brisk and very brisk] were estimated using Cox regression models, adjusted for multiple possible confounders. Data were collected from 1999 to 2019, and analysed in 2020.

RESULTS

Participants who walked at a very brisk pace at baseline had a substantially lower risk of developing hypertension during follow-up than those who walked at a slow pace (multivariable-adjusted hazard ratio: 0.64; 95% CI: 0.41-0.99). Inverse associations were observed also for normal (HR: 0.64; 95% CI: 0.46-0.90) and brisk walking pace (0.69; 95% CI: 0.50-0.97) as compared to slow pace, independent of other risk factors.

CONCLUSION

Our results support that an increase in walking pace, even slightly, is inversely associated with the development of hypertension, independent of total time spent walking and other factors associated with hypertension.

The Study of Walking, Walkability and Wellbeing in Immersive Virtual Environments

Recent approaches in the research on walkable environments and wellbeing go beyond correlational analysis to consider the specific characteristics of individuals and their interaction with the immediate environment. Accordingly, a need has been accentuated for new human-centered methods to improve our understanding of the mechanisms underlying environmental effects on walking and consequently on wellbeing. Immersive virtual environments (IVEs) were suggested as a potential method that can advance this type of research as they offer a unique combination between controlled experimental environments that allow drawing causal conclusions and a high level of environmental realism that supports ecological validity. The current study pilot tested a walking simulator with additional sensor technologies, including biosensors, eye tracking and gait sensors. Results found IVEs to facilitate extremely high tempo-spatial-resolution measurement of physical walking parameters (e.g., speed, number of gaits) along with walking experience and wellbeing (e.g., electrodermal activity, heartrate). This level of resolution is useful in linking specific environmental stimuli to the psychophysiological and behavioral reactions, which cannot be obtained in real-world and self-report research designs. A set of guidelines for implementing IVE technology for research is suggested in order to standardize its use and allow new researchers to engage with this emerging field of research.

Walking activity in a large cohort of boys with Duchenne muscular dystrophy

INTRODUCTION

In this study we explored walking activity in a large cohort of boys with Duchenne muscular dystrophy (DMD).

METHODS

Step activity (monitored for 7 days), functional ability, and strength were quantified in ambulatory boys (5-12.9 years of age) with DMD and unaffected boys. Ambulatory status was determined 2 years later.

RESULTS

Two to 5 days of activity monitoring predicted weekly step activity (adjusted R² = 0.80-0.95). Age comparisons revealed significant declines for step activity with increasing age, and relationships were found between step activity with both function and strength (P < .01). Our regression model predicted 36.5% of the variance in step activity. Those who were still ambulatory after 2 years demonstrated baseline step activity nearly double that of those who were no longer walking 2 years later (P < .01).

DISCUSSION

Step activity for DMD is related to and predictive of functional declines, which may be useful for clinical trials.

Exercise and Hypertension

Hypertension is a fatal yet preventable risk factor for cardiovascular disease and is responsible for majority of cardiovascular mortality. Hypertension is closely associated with inactive lifestyle. Physical activity and/or exercise are shown to delay development of hypertension. Both aerobic and resistance exercise have been proven to reduce blood pressure (BP) effectively. Since brisk walking is an easy, inexpensive, simple, and effective way of exercise, this type of an aerobic workout can be recommended to society. All professional organizations and government bodies recommend moderate-intensity aerobic exercise for at least 30 min on at least 3 days of the week or resistance exercise on 2-3 days of the week. Exercise sessions can either be continuous for 30 min or be composed of at least 10 min of short exercise duration to a daily total of 30 min. After an exercise session, BP decreases, and this decline continues for up to 24 h; which is called post-exercise hypotension. Overall 5 mmHg decrease in BP with regular exercise may be ensured. With a decrease of 5 mmHg in systolic BP, mortality due to coronary heart disease decreases by 9%, mortality due to stroke decreases by 14% and all-cause mortality decreases by 7%. Regular exercise should therefore be recommended for all individuals including normotensives, prehypertensives, and hypertensives.

Performance analysis of walking of 10,000 regular users of a connected activity tracker

BACKGROUND

According to the World Health Organization, individuals should walk 10,000 per day. Our aim was to determine the factors influencing this objective by using connected activity trackers.

METHODS

Anonymized data of 10,000 regular users of the Withings pulse O_x over a 3-month period.

RESULTS

Ratio men/women was 2.2, mean age 44.9±10.6 years, mean BMI 27.0±5.3kg/m², proportion of individuals living in big towns 21.4%, proportion of physical activity<2 METs 66%. The frequency of achieving 10,000 daily steps was similar for work days, weekends and whole weeks. Mean number of daily steps, mean daily covered distances and slopes were higher during work days (P<0.0001); mean speed was higher during the weekends (P<0.0001). According to a quartile-repartition (percentages of use-days with 10,000 steps), the goal was more often achieved during work days (P<0.0001), if BMI<25kg/m² (P<0.001), in individuals living in big towns (P<0.001) or having≥2 acquaintances to take up challenges (P<0.001).

CONCLUSION

Connected activity trackers represent a valuable tool for evaluating the number of daily steps and for providing feedback to promote walking.

Impact of a walking program of 10,000 steps per day and dietary counseling on health-related quality of life, energy expenditure and anthropometric parameters in obese subjects

PURPOSE

The aim of this pilot study was to assess the impact of a physical activity program of walking 10,000 steps per day along with monthly dietary counseling on the body composition, biological parameters, resting energy expenditure (REE) and health-related quality of life (HRQoL) of obese individuals.

METHODS

Thirty-five obese adults (26 women; age: 39.2 ± 13.4 years, body mass, BM: 104.1 ± 18.7 kg and body mass index, BMI: 38.3 ± 6.6 kg m^-2) followed a walking program (instructions were provided so that the participants increase their walking distance by 1000 steps each week, until to perform at least 10,000 steps per day) and received qualitative dietary advice (cookbook presenting numerous recipes with low calories and dietary advices was provided) for 6 months. Before and after the intervention, anthropometric (BM, BMI, waist and hip circumferences, fat mass: FM and lean body mass: LBM) and biological data (total cholesterol, high-density lipoprotein, low-density lipoprotein, triglyceride and glucose concentrations), REE and HRQoL (including eight dimensions and two summaries) were assessed.

RESULTS

After the intervention, BM (difference: 3.8 kg or 3.7 %), BMI (difference: 1.4 kg m^-2 or 3.7 %), hip circumference (difference: 4.6 cm or 4.3 %), FM in kg (difference: 4.0 kg or 8.9 %) and FM in percentage of BM (difference: 1.6 kg or 6.1 %) were significantly decreased, whereas number of steps (difference: 7579 steps or 135 %), LBM in percentage of BM (difference: 2.6 kg or 4.5 %) and REE (difference: 78 kcal d^-1 or 4.8 %) were significantly increased (p < 0.05). Moreover, two HRQoL subdimension scores (physical functioning and physical component summary; increase by 15.3 and 4.6, respectively, p < 0.05) and anxiety (reduction by 1.2, p < 0.05) were also significantly improved. Conversely, the biological data showed no significant change (p > 0.05).

CONCLUSION

Walking 10,000 steps per day in association with dietary counseling improved anthropometric data, REE, the physical domains of HRQoL and anxiety in obese adults.

Physical activity promotion in the primary care setting in pre- and type 2 diabetes - the Sophia step study, an RCT

Background

Physical activity prevents or delays progression of impaired glucose tolerance in high-risk individuals. Physical activity promotion should serve as a basis in diabetes care. It is necessary to develop and evaluate health-promoting methods that are feasible as well as cost-effective within diabetes care. The aim of Sophia Step Study is to evaluate the impact of a multi-component and a single component physical activity intervention aiming at improving HbA_1c (primary outcome) and other metabolic and cardiovascular risk factors, physical activity levels and overall health in patients with pre- and type 2 diabetes.

Methods/design

Sophia Step Study is a randomized controlled trial and participants are randomly assigned to either a multi-component intervention group (A), a pedometer group (B) or a control group (C). In total, 310 patients will be included and followed for 24 months. Group A participants are offered pedometers and a website to register steps, physical activity on prescription with yearly follow-ups, motivational interviewing (10 occasions) and group consultations (including walks, 12 occasions). Group B participants are offered pedometers and a website to register steps. Group C are offered usual care. The theoretical framework underpinning the interventions is the Health Belief Model, the Stages of Change Model, and the Social Cognitive Theory. Both the multi-component intervention (group A) and the pedometer intervention (group B) are using several techniques for behavior change such as self-monitoring, goal setting, feedback and relapse prevention.

Measurements are made at week 0, 8, 12, 16, month 6, 9, 12, 18 and 24, including metabolic and cardiovascular biomarkers (HbA_1c as primary health outcome), accelerometry and daily steps. Furthermore, questionnaires were used to evaluate dietary intake, physical activity, perceived ability to perform physical activity, perceived support for being active, quality of life, anxiety, depression, well-being, perceived treatment, perceived stress and diabetes self- efficacy.

Discussion

This study will show if a multi-component intervention using pedometers with group- and individual consultations is more effective than a single- component intervention using pedometers alone, in increasing physical activity and improving HbA_1c, other metabolic and cardiovascular risk factors, physical activity levels and overall health in patients with pre- and type 2 diabetes.

Trial registration

ClinicalTrials.gov Identifier: NCT02374788. Registered 28 January 2015.

Physical Activity for Campus Employees: A University Worksite Wellness Program

BACKGROUND

Workplaces provide ideal environments for wellness programming. The purpose of this study was to explore exercise self-efficacy among university employees and the effects of a worksite wellness program on physical activity, cardiorespiratory fitness, and cardiovascular disease (CVD) risk factors.

METHODS

Participants included 121 university employees (85% female). The worksite wellness program included cardiovascular health assessments, personal health reports, 8 weeks of pedometer-based walking and tracking activities, and weekly wellness sessions. Daily step count was assessed at baseline, Week 4, and Week 8. Exercise self-efficacy and CVD risk factors were evaluated at baseline and follow-up.

RESULTS

Daily step count increased from 6566 ± 258 (LSM ± SE) at baseline to 8605 ± 356 at Week 4 and 9107 ± 388 at Week 8 (P < .0001). Steps increased among normal weight, overweight, and obese subgroups. Exercise self-efficacy correlated with baseline steps (P < .05). Small improvements were observed in cardiorespiratory fitness, body mass index, blood pressure, blood glucose, total cholesterol, and triglycerides (all P < .01).

CONCLUSIONS

A worksite wellness program was effective for improving physical activity, cardiorespiratory fitness, and CVD risk factors among university employees. Exercise barriers and outcome expectations were identified and have implications for future worksite wellness programming.

U.S. Cohort Differences in Body Composition Outcomes of a 6-Month Pedometer-Based Physical Activity Intervention: The ASUKI Step Study

Background:

Regular physical activity (PA) enhances health and is an important factor in disease prevention and longevity. The 2008 U.S. Physical Activity Guidelines recommends that all healthy adults attain at least 150 minutes per week of moderate intensity aerobic PA (e.g., brisk walking) to maintain and promote PA.

Objectives:

This study determined the effects of a 6-month pedometer-based worksite walking intervention with participants focusing on a goal of achieving 10,000 steps per day, on body composition in adults with a wide range of body mass index (BMI) values and compares the changes with outcomes of similar studies.

Materials and Methods:

The design was a single group, quasi-experimental study. All participants received a pedometer and were asked to register the daily number of steps. Men and women (n = 142; age = 41 ± 11.5 years; BMI = 27.2 ± 7.25 kg.m^-2) received body composition measures at 1, 3, and 6 months. A multilevel growth modeling approach was used to explore change over time and to predict change by steps, age, gender, and fat category categorized as normal and overweight/obese.

Results:

Significant individual differences in linear slopes and change over time were observed for waist circumference (WC) (-3.0 cm) only in unconditional model (t = -0.67, P = 0.02).

Conclusions:

A 3.0 cm loss in WC shows that a 10,000 step per day walking program has the potential to influence changes in body composition measures that are correlated with adverse health outcomes. While significant changes did occur there are some limitations. The analysis did not consider the data regarding completing of 10,000 steps per day and other potential factors that could influence the results. Compliance to the walking dose and initial physical activity and body composition levels are important to consider when studying body composition changes in such programs.

Physical activity and the prevention of hypertension

As the worldwide prevalence of hypertension continues to increase, the primary prevention of hypertension has become an important global public health initiative. Physical activity is commonly recommended as an important lifestyle modification that may aid in the prevention of hypertension. Recent epidemiologic evidence has demonstrated a consistent, temporal, and dose-dependent relationship between physical activity and the development of hypertension. Experimental evidence from interventional studies has further confirmed a relationship between physical activity and hypertension as the favorable effects of exercise on blood pressure reduction have been well characterized in recent years. Despite the available evidence strongly supporting a role for physical activity in the prevention of hypertension, many unanswered questions regarding the protective benefits of physical activity in high-risk individuals, the factors that may moderate the relationship between physical activity and hypertension, and the optimal prescription for hypertension prevention remain. We review the most recent evidence for the role of physical activity in the prevention of hypertension and discuss recent studies that have sought to address these unanswered questions.