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Simple Pedometer-Based Walking Programs Help Overweight, Sedentary Adults

Posted: Wednesday, February 27, 2008

Once again, the use of a ten dollar pedometer along with a walking program, shows its effectiveness in improving peoples health and quality of life.

Pedometer-based walking programs results in a modest amount of weight loss for overweight, sedentary adults, according to the results of a meta-analysis reported in the January/February issue of the Annals of Family Medicine.

Obesity in the United States is increasing rapidly and reaching epidemic proportions, as are type 2 diabetes and other chronic illnesses related to obesity. Diet and exercise modifications help prevent both obesity and type 2 diabetes, and observational studies have shown that people who walk more tend to be thinner than those who walk less.

Pedometer-based walking programs may facilitate weight loss during dietary interventions and help prevent weight regain after significant weight loss. These programs allow individuals to meet high step-count goals in a flexible fashion, either by taking 1 long walk or by increasing the number of very short walks spread throughout the day. This meta-analysis looks at the effects of pedometer-based walking interventions on weight loss in the absence of dietary intervention in overweight or obese, sedentary adults.

"Cross-sectional studies show that individuals who walk more tend to be thinner than those who walk less," write Caroline R. Richardson, MD, from the University of Michigan Medical School in Ann Arbor, and colleagues. "This does not mean, however, that the association between higher step counts and lower weight is causal or that encouraging sedentary individuals to increase step counts helps them lose weight."

The authors searched 6 electronic databases and contacted pedometer experts to find pedometer-based walking studies without a dietary intervention that reported weight change as an outcome. Inclusion criteria were randomized controlled trials and prospective cohort studies published after January 1, 1995, in either English or Japanese, with at least 5 adult participants and 1 or more cohorts enrolled in a pedometer-based walking intervention of at least 4 weeks' duration.

In 9 studies that met inclusion criteria, cohort sample size ranged from 15 to 106. Among the total of 307 participants, 73% were women, and 27% were men. Median duration of the intervention was 16 weeks (range, 4 weeks to 1 year).

Using a fixed-effects model and combining data from all 9 cohorts, the pooled estimate of mean weight change from baseline was –1.27 kg (95% confidence interval [CI], –1.85 to –0.70 kg). Longer duration of the intervention was associated with greater weight change. Average weight loss during the interventions was 0.05 kg/week.

"Pedometer-based walking programs result in a modest amount of weight loss," the authors write. "Longer programs lead to more weight loss than shorter programs."

Study limitations include preintervention-postintervention comparisons rather than comparisons between randomized groups; possible overestimate or underestimate of the effect of the pedometer-based walking intervention; and the possibility that participants decreased caloric intake.

"Pedometer-based walking programs without a dietary intervention component do result in a modest amount of weight loss," the study authors conclude. "Pedometer-based walking programs also do increase step counts and thus can be expected to confer health benefits that are associated with both a modest decrease in weight and an increase in physical activity."

The National Institutes of Health provided funding for this study. The University of Michigan Medical School Student Biomedical Research Program supported the time spent by one of the authors. The authors have disclosed no relevant financial relationships.

Practice Pearls

A meta-analysis shows that pedometer-based walking programs without dietary intervention result in a modest amount of weight loss in overweight or obese, sedentary participants. Because pedometer-based walking programs increased step counts, they could be expected to provide health benefits associated with both a modest decrease in weight and an increase in physical activity.
There was a strong linear association between the duration of intervention and the magnitude of weight change, with interventions of longer duration associated with greater weight change.

Source: Diabetes In Control: Ann Fam Med. 2008;6:69-77.