# Exercise as it relates to Disease/Health benefits of a pedometer-based physical activity intervention in sedentary workers

Journal Article Review: Health Benefits of a pedometer-based physical activity intervention in sedentary workers

## Background of the Research

Sedentary behaviour also known as physical inactivity is defined as any waking activity characterised by an energy expenditure less than 1.5 metabolic equivalents or METs. Sedentary behaviour is considered any time during waking hours a person is sitting or lying down. A sedentary lifestyle has been shown to have serious affects upon individual’s health status. The World Health Organisation (WHO) reported that a sedentary lifestyle could be in the top 10 leading causes of disease and disability. In the same report WHO reported that individuals leading a sedentary lifestyle have an increased risk of mortality. The same population also are two times more likely to develop health issues such as cardiovascular disease, diabetes, obesity, many types of cancer, hypertension, depression, anxiety and a number of other issues.
Due to the multitude of health problems a sedentary lifestyle is not only localised to the individual but increases cost of health. In this population it was estimated that the economic cost of physical inactivity in 2001 was $5.3 billion, which equated to approximately 2.6% of all health costs in Canada.
The background to the study was to see if a simple intervention using a pedometer causes improvements in time spent being physically active for individuals that work in sedentary jobs.

## Where is the Research from

The research was a Canadian study, which was conducted in the province of Prince Edward Island. Prince Edward Island was chosen as a suitable place due to the average BMI being higher than the national average and the amount of time spent conducting in physical activity was lower compared to other provinces.

## What Kind of Research was it

The study conducted was an intervention study over 12 weeks where they looked at if a particular intervention (PEI-FSP) could help address the issue of sedentary work lives.

## What did the Research Involve
### Adoption Phase

The first phase of the program was termed the adoption phase. This phase ran for the first 4 weeks. This part of the study consisted of participants meeting for 30-60mins every week in a group with a facilitator provided to run the program. Facilitators taught the participants about the benefits of becoming more active, learning behaviours to achieve new activity goals, and learning strategies to overcome relapses. During this phase the participants would on a weekly basis set individual steps per day goals this would be self monitored using the pedometer provided to record daily steps. The recording was done by either entering steps into a diary or into an online portal designed for the study. The participants were only required to wear the pedometer during waking hours.

### Adherence Phase

Weeks 5 to 12 comprised of the adherence phase. During this phase the participants no longer had contact with their facilitator but rather continued to self monitor their progress. They were instructed during this phase to adjust and reset daily step goals as deemed necessary.

## What were the Basic Results

The participants were tested twice throughout the study. Once at the start to assess baseline measures of several health indicators, and at the end of the program to assess changes in their health indicators.

### Baseline Results

| Health Indicators | Mean ± SD |
| Weight (kg) | 79.4 ± 17.3 |
| BMI (kg/m²) | 29.5 ± 5.94 |
| Waist Girth (cm) | Male: 91.2 ± 13.8 |
| Waist Girth (cm) | Female: 88.9 |
| Resting Heart Rate (bpm) | 75.4 ± 10.4 |
| Systolic Blood Pressure | 128.2 ± 17.0 |
| Diastolic Blood Pressure | 77.6 ± 10.3 |
| Steps per day | 7,029 ± 3,100 |

### Post Results

It is somewhat hard to determine the exact results as there was no published comparison between baseline results and post program results. What was stated was that there were significant negative changes in body weight, BMI, waist girth and heart rate. It was interesting to note there was found to be no difference in blood pressure for the start of the program to the end. Steps per day increased to 10,480 ± 3,224

## How did the Researcher interpret these Results

The researchers made some interesting conclusions from the results obtained and correlations that were run. They concluded:
* An increase in the number of steps per day was associated with improvements in waist girth and resting heart rate.
* A handful of participants who had decreased steps per day decreased their BMI. It was hypothesised that this was due to a multitude of other factors such as initial underestimation, change in lifestyle behaviours, or taking part in other activities outside the program.
* An increase in steps per day did not influence the amount of change in BMI. It was judged that the higher the baseline steps the greater the decrease in BMI.
The last point is important and concluded that there may be a threshold of activity required to have weight loss and therefore impact BMI.

## What conclusions should be taken away

A key conclusion that can be drawn from this particular study is that physical activity can be increased via a simple intervention such as the one studied. This can be achieved by simply increasing the amount of steps taken per day. An increase in physical activity is linked to improvements in health indicators and the research looked to support this with decreases in body weight, BMI, waist girth and resting heart rate for the participants involved. This then leads to the conclusion that simply increasing steps per day people could better their health and well being.

## Implications of Research

People who lead a sedentary lifestyle have been proven to be at a greater risk of developing obesity. This alone has a multitude of problems. This could also have a flow on effect as individuals who are sedentary could develop other disease states. The typical working day is around half the amount of time people are awake. For people with families and various other commitments this could leave little time to gain sufficient physical activity in a day particularly in individuals with sedentary jobs.
There have been other studies that support that physical activity in the form of increasing steps per day can have positive effects on disease states this was the first investigation into the use of this method in sedentary workers.
The implication that can be taken from this piece of research is an increase in steps per day can have a positive effect on a persons health and well being. Whilst this is an important factor and a great place to start we also need to remember that this alone is not enough neither will this alone stop the problems with a sedentary lifestyle. Individuals still need to make whole lifestyle changes. A limitation with this research could be that it only look at one factor, which is steps per day. Steps will eventually reach a ceiling effect where it is hard to increase further due to constraints of daily living. For this reason people need to look at broader lifestyle choices rather than just steps per day to counteract the sedentary behaviours.

## References

* ↑ Chan C.B, Ryan D.A, Tudor-Locke C. Health benefits of a pedometer-based physical activity intervention in sedentary workers. Journal or preventative medicine, 39, 2004,1215-1222
* ↑ Sedentary Behaviour Research Network. 2012. Standardized use of the terms “sedentary” and “sedentary behaviours”. Appl Physiol Nutr Metab. 37: 540–542.
* ↑ Prakash, R 'physical inactivity a leading cause of disease' 2002
* ↑ Peter T. Katzmarzyk, Ian Janssen, The Economic Costs Associated With Physical Inactivity and Obesity in Canada: An Update, Canadian Journal of Applied Physiology, 2004, 29(1): 90-115
* ↑ Sugiura, H et al, Effects of long-term moderate exercise and increase in number of daily steps on scrum lipids in women: randomised trial. BMC women health, 2002, 2,3
* ↑ Penedo, Frank J; Dahn, Jason R, Exercise and well-being: a review of mental and physical health benefits associated with physical activity, Behavioural medicine, Vol 12 issue 2, 189-193
* ↑ Dena M. Bravata et al,Using Pedometers to Increase Physical Activity and Improve Health. JAMA. 2007;298(19):2296-2304
* ↑ C Tudor-Locke et al,Controlled outcome evaluation of the First Step Program: a daily physical activity intervention for individuals with type II diabetes, International Journal of Obesity (2004) 28, 113–119
* ↑ Mark Stephen Tremblay, Rachel Christine Colley, Travis John Saunders, Genevieve Nissa Healy, and Neville Owen, Physiological and health implications of a sedentary lifestyle,Appl. Physiol. Nutr. Metab, vol 35, 725-740