JMIR Publications

ABSTRACT

Background:

Best practice early interventions to increment physical activity in children with overweight/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 is performed by children with overweight/obesity (as proportion of total PA level) in order to determine its utility as a public health strategy.

Objective:

This study aimed to: 1) investigate the proportion of overall physical activity (PA) indicators that are explained by step-based metrics; and, 2) to study step accumulation patterns relative to achievement of public health recommendations in children with overweight/obesity.

Methods:

One-hundred and five overweight/obese children (10±1 year, 43 girls) were assessed with hip-worn accelerometers for 7 days. Counts/15s were used to derive overall PA indicators (i.e., daily average of counts/15s, light-to-vigorous PA [LMVPA], and moderate-to-vigorous PA [MVPA]). Step-based metrics included volume (steps/day) and intensity (cadence bands and peak 1, 30 and 60-min cadences).

Results:

Steps/day explained 66%, 40% and 74% of variance for counts/15s, LMVPA and MVPA, respectively. The variance explained was increased up to 80%, 92% and 77% by including specific cadence bands and peak cadences. Children who achieved the recommended 60 min/day of MVPA spent less time in zero cadence and more time in cadence bands representing sporadic movement to brisk walking (20-120 steps/min) than their less-active peers.

Conclusions:

Step-based metrics, including steps/day and various cadence-based indicators, seem to capture a large proportion of PA for children with overweight/obesity. Given the affordability of pedometers, step-based metrics could be useful for discriminating between those children who do or do not achieve MVPA recommendations. Clinical Trial: NCT02295072