Toward Comprehensive Step-Based Physical Activity Guidelines: Are We Ready?

in Kinesiology Review

Click name to view affiliation

Catrine Tudor-Locke
Search for other papers by Catrine Tudor-Locke in
Current site
Google Scholar
PubMedClose
and
Elroy J. Aguiar
Search for other papers by Elroy J. Aguiar in
Current site
Google Scholar
PubMedClose
DOI:
https://doi.org/10.1123/kr.2018-0065
Keywords:
cadence; pedometer; steps/day; walking; wearable technology
In Print:
Volume 8: Issue 1
Page Range:
25–31
Restricted access

Step counting is now a widespread and acceptable approach to self-monitoring physical activity courtesy of the recent surge in wearable technologies. Nonetheless, there remains no recommendation for steps/day in federal physical activity guidelines. The authors review current scientific literature to consider evidence regarding the volume, dose (frequency, intensity, duration, timing), and dose-response relationships for step-based metrics, including steps/day (volume), cadence (steps/min; intensity), peak 30-min cadence (steps/min; composite index of frequency, intensity, and duration), and zero cadence (proxy for sedentary behavior). Preliminary evidence suggests that communicating federal physical activity guidelines using step-based metrics could facilitate individuals’ ability to comprehend and achieve a physically active lifestyle.

The authors are with the Dept. of Kinesiology, University of Massachusetts Amherst, Amherst, MA.

Tudor-Locke (ctudorlocke@umass.edu) is corresponding author.
  • Collapse
  • Expand

Kinesiology Review

Cover Kinesiology Review

  • 2018 Physical Activity Guidelines Advisory Committee. (2018). 2018 Physical Activity Guidelines Advisory Committee scientific report. U.S. Department of Health and Human Services. Retrieved from https://health.gov/paguidelines/second-edition/report.aspx

    • Search Google Scholar
    • Export Citation

  • Aguiar, E.J., Morgan, P.J., Collins, C.E., Plotnikoff, R.C., Young, M.D., & Callister, R. (2016). Efficacy of the Type 2 diabetes Prevention Using LifeStyle Education program RCT. American Journal of Preventive Medicine, 50(3), 353–364. PubMed ID: 26526160 doi:10.1016/j.amepre.2015.08.020

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Althoff, T., Sosic, R., Hicks, J.L., King, A.C., Delp, S.L., & Leskovec, J. (2017). Large-scale physical activity data reveal worldwide activity inequality. Nature, 547(7663), 336–339. PubMed ID: 28693034 doi:10.1038/nature23018

    • Crossref
    • Search Google Scholar
    • Export Citation

  • American Heart Association. (1992). Statement on exercise: Benefits and recommendations for physical activity programs for all Americans. A statement for health professionals by the Committee on Exercise and Cardiac Rehabilitation of the Council on Clinical Cardiology, American Heart Association. Circulation, 86(1), 340–344.

    • Search Google Scholar
    • Export Citation

  • Bassett, D.R., Jr., Toth, L.P., LaMunion, S.R., & Crouter, S.E. (2017). Step counting: A review of measurement considerations and health-related applications. Sports Medicine, 47(7), 1303–1315. PubMed ID: 28005190 doi:10.1007/s40279-016-0663-1

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Colberg, S.R., Sigal, R.J., Yardley, J.E., Riddell, M.C., Dunstan, D.W., Dempsey, P.C., . . . Tate, D.F. (2016). Physical activity/exercise and diabetes: A position statement of the American Diabetes Association. Diabetes Care, 39(11), 2065–2079. PubMed ID: 27926890 doi:10.2337/dc16-1728

    • Crossref
    • Search Google Scholar
    • Export Citation

  • DiPietro, L., Gribok, A., Stevens, M.S., Hamm, L.F., & Rumpler, W. (2013). Three 15-min bouts of moderate postmeal walking significantly improves 24-h glycemic control in older people at risk for impaired glucose tolerance. Diabetes Care, 36(10), 3262–3268. PubMed ID: 23761134 doi:10.2337/dc13-0084

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Dwyer, T., Pezic, A., Sun, C., Cochrane, J., Venn, A., Srikanth, V., . . . Ponsonby, A.L. (2015). Objectively measured daily steps and subsequent long term all-cause mortality: The Tasped prospective cohort study. PLoS One, 10(11), 0141274. PubMed ID: 26536618 doi:10.1371/journal.pone.0141274

    • Search Google Scholar
    • Export Citation

  • Felton, G.M., Tudor-Locke, C., & Burkett, L. (2006). Reliability of pedometer-determined free-living physical activity data in college women. Research Quarterly for Exercise and Sport, 77(3), 304–308. PubMed ID: 17020074 doi:10.1080/02701367.2006.10599364

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Garber, C.E., Blissmer, B., Deschenes, M.R., Franklin, B.A., Lamonte, M.J., Lee, I.M., . . . American College of Sports Medicine. (2011). American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise. Medicine and Science in Sports and Exercise, 43(7), 1334–1359. PubMed ID: 21694556 doi:10.1249/MSS.0b013e318213fefb

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Hatano, Y. (1993). Use of the pedometer for promoting daily walking exercise. International Council for Health, Physical Education, and Recreation, 29(4), 4–8.

    • Search Google Scholar
    • Export Citation

  • Hulteen, R.M., Smith, J.J., Morgan, P.J., Barnett, L.M., Hallal, P.C., Colyvas, K., & Lubans, D.R. (2017). Global participation in sport and leisure-time physical activities: A systematic review and meta-analysis. Preventive Medicine, 95 ,14–25. PubMed ID: 27939265 doi:10.1016/j.ypmed.2016.11.027

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Izawa, K.P., Watanabe, S., Oka, K., Hiraki, K., Morio, Y., Kasahara, Y., . . . Shimizu, H. (2013). Usefulness of step counts to predict mortality in Japanese patients with heart failure. American Journal of Cardiology, 111(12), 1767–1771. PubMed ID: 23540653 doi:10.1016/j.amjcard.2013.02.034

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Kraus, W.E., Yates, T., Tuomilehto, J., Sun, J.-L., Thomas, L., McMurray, J.J.V., . . . Holman, R.R. (2018). Relationship between baseline physical activity assessed by pedometer count and new-onset diabetes in the Navigator trial. BMJ Open Diabetes Research & Care, 6(1), e000523. PubMed ID: 30073088 doi:10.1136/bmjdrc-2018-000523

    • Crossref
    • Search Google Scholar
    • Export Citation

  • MacLeod, S.F., Terada, T., Chahal, B.S., & Boule, N.G. (2013). Exercise lowers postprandial glucose but not fasting glucose in Type 2 diabetes: A meta-analysis of studies using continuous glucose monitoring. Diabetes/Metabolism Research and Reviews, 29(8), 593–603. PubMed ID: 24038928 doi:10.1002/dmrr.2461

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Pate, R.R., Pratt, M., Blair, S.N., Haskell, W.L., Macera, C.A., Bouchard, C., . . . Wilmore, J.H. (1995). Physical activity and public health: A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. Journal of the American Medical Association, 273(5), 402–407. PubMed ID: 7823386 doi:10.1001/jama.273.5.402

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Ponsonby, A.L., Sun, C., Ukoumunne, O.C., Pezic, A., Venn, A., Shaw, J.E., . . . Dwyer, T. (2011). Objectively measured physical activity and the subsequent risk of incident dysglycemia: The Australian diabetes, obesity and lifestyle study (AusDiab). Diabetes Care, 34(7), 1497–1502. PubMed ID: 21562319 doi:10.2337/dc10-2386

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Schuna, J.M., Jr., Brouillette, R.M., Foil, H.C., Fontenot, S.L., Keller, J.N., & Tudor-Locke, C. (2013). Steps per day, peak cadence, body mass index, and age in community-dwelling older adults. Medicine and Science in Sports and Exercise, 45(5), 914–919. PubMed ID: 23247705 doi:10.1249/MSS.0b013e31827e47ac

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Troiano, R.P., McClain, J.J., Brychta, R.J., & Chen, K.Y. (2014). Evolution of accelerometer methods for physical activity research. British Journal of Sports Medicine, 48(13), 1019–1023. PubMed ID: 24782483 doi:10.1136/bjsports-2014-093546

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Tudor-Locke, C., & Bassett, D.R. (2004). How many steps/day are enough? Preliminary pedometer indices for public health. Sports Medicine, 34(1), 1–8. PubMed ID: 14715035 doi:10.2165/00007256-200434010-00001

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Tudor-Locke, C., Bassett, D.R., Swartz, A.M., Strath, S.J., Parr, B.B., Reis, J.P., . . . Ainsworth, B.E. (2004). A preliminary study of one year of pedometer self-monitoring. Annals of Behavioral Medicine, 28(3), 158–162. PubMed ID: 15576253 doi:10.1207/s15324796abm2803_3

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Tudor-Locke, C., Brashear, M.M., Katzmarzyk, P.T., & Johnson, W.D. (2012). Peak stepping cadence in free-living adults: 2005–2006 NHANES. Journal of Physical Activity and Health, 9(8), 1125–1129. PubMed ID: 22207030 doi:10.1123/jpah.9.8.1125

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Tudor-Locke, C., Burkett, L., Reis, J.P., Ainsworth, B.E., Macera, C.A., & Wilson, D.K. (2005). How many days of pedometer monitoring predict weekly physical activity in adults? Preventive Medicine, 40(3), 293–298. PubMed ID: 15533542 doi:10.1016/j.ypmed.2004.06003

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Tudor-Locke, C., Camhi, S.M., Leonardi, C., Johnson, W.D., Katzmarzyk, P.T., Earnest, C.P., & Church, T.S. (2011). Patterns of adult stepping cadence in the 2005–2006 NHANES. Preventive Medicine, 53(3), 178–181. PubMed ID: 21708187 doi:10.1016/j.ypmed.2011.06.004

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Tudor-Locke, C., Craig, C.L., Brown, W.J., Clemes, S.A., De Cocker, K., Giles-Corti, B., . . . Blair, S.N. (2011). How many steps/day are enough? For adults. International Journal of Behavioral Nutrition and Physical Activity, 8 ,79. PubMed ID: 21798015 doi:10.1186/1479-5868-8-79

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Tudor-Locke, C., Craig, C.L., Thyfault, J.P., & Spence, J.C. (2013). A step-defined sedentary lifestyle index: <5000 steps/day. Applied Physiology, Nutrition, and Metabolism, 38(2), 100–114. PubMed ID: 23438219 doi:10.1139/apnm-2012-0235

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Tudor-Locke, C., Han, H., Aguiar, E.J., Barreira, T.V., Schuna, J.M., Jr., Kang, M., & Rowe, D.A. (2018). How fast is fast enough? Walking cadence (steps/min) as a practical estimate of intensity in adults: A narrative review. British Journal of Sports Medicine, 52(12), 776–788. PubMed ID: 29858465 doi:10.1136/bjsports-2017-097628

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Tudor-Locke, C., Hart, T.L., & Washington, T.L. (2009). Expected values for pedometer-determined physical activity in older populations. International Journal of Behavioral Nutrition and Physical Activity, 6 ,59. PubMed ID: 19706192 doi:10.1186/1479-5868-6-59

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Tudor-Locke, C., Hatano, Y., Pangrazi, R.P., & Kang, M. (2008). Revisiting “how many steps are enough?” Medicine and Science in Sports and Exercise, 40(Suppl. 7), S537–543. PubMed ID: 18562971 doi:10.1249/MSS.0b013e31817c7133

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Tudor-Locke, C., Johnson, W.D., & Katzmarzyk, P.T. (2009). Accelerometer-determined steps per day in US adults. Medicine and Science in Sports and Exercise, 41(7), 1384–1391. PubMed ID: 19516163 doi:10.1249/MSS.0b013e318199885c

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Tudor-Locke, C., Johnson, W.D., & Katzmarzyk, P.T. (2011). Relationship between accelerometer-determined steps/day and other accelerometer outputs in US adults. Journal of Physical Activity and Health, 8(3), 410–419. PubMed ID: 21487141 doi:10.1123/jpah.8.3.410

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Tudor-Locke, C., & Rowe, D.A. (2012). Using cadence to study free-living ambulatory behaviour. Sports Medicine, 42(5), 381–398. PubMed ID: 22462794 doi:10.2165/11599170-000000000-00000

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Tudor-Locke, C., Schuna, J.M., Jr., Barreira, T.V., Mire, E.F., Broyles, S.T., Katzmarzyk, P.T., & Johnson, W.D. (2013). Normative steps/day values for older adults: NHANES 2005–2006. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 68(11), 1426–1432. doi:10.1093/gerona/glt116

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Tudor-Locke, C., Schuna, J.M., Jr., Han, H., Aguiar, E.J., Green, M.A., Busa, M.A., . . . Johnson, W.D. (2017). Step-based physical activity metrics and cardiometabolic risk: NHANES 2005–2006. Medicine and Science in Sports and Exercise, 49(2), 283–291. PubMed ID: 27669450 doi:10.1249/MSS.0000000000001100

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Tudor-Locke, C., Sisson, S.B., Collova, T., Lee, S.M., & Swan, P.D. (2005). Pedometer-determined step count guidelines for classifying walking intensity in a young ostensibly healthy population. Canadian Journal of Applied Physiology, 30(6), 666–676. PubMed ID: 16485518 doi:10.1139/h05-147

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Tudor-Locke, C., Washington, T.L., & Hart, T.L. (2009). Expected values for steps/day in special populations. Preventive Medicine, 49(1), 3–11. PubMed ID: 19409409 doi:10.1016/j.ypmed.2009.04.012

    • Crossref
    • Search Google Scholar
    • Export Citation

  • U.S. Department of Health and Human Services. (2008). 2008 physical activity guidelines for Americans: Be active, healthy, and happy! (ODPHP Publication No. U0036). Retrieved from www.health.gov/paguidelines

    • Search Google Scholar
    • Export Citation

  • van Dijk, J.W., Tummers, K., Stehouwer, C.D., Hartgens, F., & van Loon, L.J. (2012). Exercise therapy in Type 2 diabetes: Is daily exercise required to optimize glycemic control? Diabetes Care, 35(5), 948–954. PubMed ID: 22399700 doi:10.2337/dc11-2112

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Wong, S.L., Colley, R., Connor Gorber, S., & Tremblay, M. (2011). Actical accelerometer sedentary activity thresholds for adults. Journal of Physical Activity and Health, 8(4), 587–591. PubMed ID: 21597132 doi:10.1123/jpah.8.4.587

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Yamamoto, N., Miyazaki, H., Shimada, M., Nakagawa, N., Sawada, S.S., Nishimuta, M., . . . Yoshitake, Y. (2018). Daily step count and all-cause mortality in a sample of Japanese elderly people: A cohort study. BMC Public Health, 18 ,540. doi:10.1186/s12889-018-5434-5

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Yates, T., Davies, M.J., Haffner, S.M., Schulte, P.J., Thomas, L., Huffman, K.M., . . . Kraus, W.E. (2015). Physical activity as a determinant of fasting and 2-h post-challenge glucose: A prospective cohort analysis of the Navigator trial. Diabetic Medicine, 32(8), 1090–1096. PubMed ID: 25818859 doi:10.1111/dme.12762

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Yates, T., Ner, S.M.H., Schulte, P.J., Thomas, L., Huffman, K.M., Bales, C.W., . . . Kraus, W.E. (2014). Association between change in daily ambulatory activity and cardiovascular events in people with impaired glucose tolerance (Navigator trial): A cohort analysis. Lancet, 383(9922), 1059–1066. PubMed ID: 24361242 doi:10.1016/S0140-6736(13)62061-9

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 2742 1581 13
Full Text Views 25 9 0
PDF Downloads 20 11 0