Article Figures & Data
Figures
- Figure 2.
Funnel plot test to test for publication bias. No evidence of publication bias was found.
- Figure 3.
Forest plot of effect sizes and 95% confidence intervals for all 9 cohorts, based on the random effects meta-analysis results.
- Figure 4.
Weight change by study intervention duration.
Tables
- Table 1.
Published Studies of Pedometer-Based Walking Interventions That Met Inclusion Criteria
Study (Year) No. of Participantsa (Study Design) Population Dropout No. (%) Weight-Related Inclusion Criteria Baseline BMI Mean ± SD (Range), kg/m2 Intervention Duration Behavioral Counseling Goal Setting in Pedometer Intervention Step-Count Logging and Reporting BMI = body mass index; RCT = randomized controlled trial. a Number represents only study completers and, for RCTs, only participants randomized to the pedometer intervention arm of the study. b Calculation was based on other data in the report. Engel and Lindner18 (2006) 22 (RCT) Sedentary men and women with type 2 diabetes with a mean age of 60.5 years 2 (8) None 32.7 ± 5.5 6 months Intensive coaching program including 6 individual sessions and a monthly newsletter Step-count walking goals chosen by the participant Time spent walking and step counts were recorded in a glucose and exercise log Wilson et al19 (2005) 22 (Cohort) African American breast cancer survivors with a mean age of 55 years 2 (8) None 32.7 (25.2–47.2) 8 weeks Eight 75-minute small group weekly sessions based on Health Belief Model Assigned progressive step goals Walks were scheduled and steps were recorded on a scheduler/tracker form and reported to study staff weekly Miyatake et al20 (2002) 31 (Cohort) Japanese men aged 32 to 59 years Not reported BMI >25 kg/m2 28.6 ± 2.2 1 year Not reported Increase daily baseline step count by 1,000 steps Not reported Schneider et al21 (2006) 38 (Cohort) Sedentary overweight or obese but otherwise healthy adults aged 30 to 60 years 18 (32) BMI >25 kg/m2 33.5 ± 5.0 36 weeks Information sessions every other week for 2 months, then once a month Gradually increase daily step count to 10,000 steps/day Steps were recorded daily in an activity log Tudor-Locke et al22 (2004) 24 (RCT) Overweight or obese, sedentary individuals with type 2 diabetes and a mean age of 52.7 years 6 (20) None 34.1 ± 6.1 16 weeks Counseling based on self-efficacy and social support; 4 weekly group meetings and a program manual Individualized step-count goal setting based on exercises in the manual Steps per day were recorded in a calendar log Swartz et al23 (2003) 18 (Cohort) Overweight or obese women with family history of type 2 diabetes 1 (5) BMI >25 kg/m2 35.0 ± 5.1 8 weeks Pedometer and step-count goal instructions only Accumulate 10,000 steps/day Steps and exercise were recorded in an activity log Moreau et al24 (2001) 15 (RCT) Sedentary, postmenopausal women with stage 1 hypertension and a mean age of 54 years Not reported None >25b 24 weeks Pedometer and step-count goal instructions only Step-count goals gradually increased to a target of 3 km over baseline Daily step counts were recorded on log sheets that were collected every 2 weeks Hultquist et al25 (2005) 31 (RCT) Sedentary, healthy, nonsmoking women aged 33 to 55 years 0 (0) BMI <40 kg/m2 30 ± 6.4 4 weeks Pedometer and step-count goal instructions only 10,000 daily steps Step counts were recorded on a pedometer with a 7-day memory and collected weekly Chan et al26 (2004) 106 (Cohort) Sedentary workers with a mean age of 43 years 71 (40) None 29.5 ± 5.9 12 weeks Counseling based on self-efficacy and social support; 4 weekly group meetings Individualized goal setting Step-count goals and tracking were logged on a Web site Step Count Weight, kg Study (Year) Preintervention Postintervention Change Preintervention Postintervention Change NR = not reported in the study report. Note: Preintervention and postintervention values are expressed as means or as means ± standard deviations, except as indicated below. a Calculation was based on other data in the study report. b Difference between the preintervention and postintervention values was significant at the .05 level. c Means ± standard errors. Engel and Lindner18 (2006) NR 7,296±2,066 NR 91.9±18.4 89.8a −2.1a Wilson et al19 (2005) 4,791 8,297a 3,506 86.7 85.8 −0.9b Miyatake et al20 (2002) 7,013±3,077 8,840±4,342 1,827 82.3±7.4 78.6±7.4 −3.7b Schneider et al21 (2006) 5,123±1,271 9,117±1,697 3,994 98.8±18.6 96.4±17.8 −2.4b Tudor-Locke et al22 (2004) 5,753a 9,123±4,539 3,370 96.8±23.9 96.1±22.8 −0.7 Swartz et al23 (2003) 4,972±419c 9,213±362c 4,241 94.0±3.6 94.3±3.4c +0.3 Moreau et al24 (2001) 5,400±500c 9,700±400c 4,300 81.1±5.9 79.8±5.8 −1.3b Hultquist et al25 (2005) 5,603±1,214 10,159±292c 4,556 82.0±3.1c 81.5±3.1c −0.5 Chan et al26 (2004) 7,029±3,100 10,480±3,224 3,451 79.4±17.3 77.9a −1.5a,b
The Article in Brief
A Meta-Analysis of Pedometer-Based Walking Interventions and Weight Loss
Caroline R. Richardson, MD , and colleagues
Background People who walk more tend to be thinner than those who walk less. This study examines the effects of walking programs for overweight adults that use pedometers (small devices worn at the waist that count every step taken during the day).
What This Study Found Walking programs that use a pedometer as a motivational tool result in a moderate amount of weight loss in overweight or obese sedentary adults. The average participant in a pedometer-based walking program without dietary change can expect to lose about 1 pound every 10 weeks, or about 5 pounds per year. Longer programs are associated with greater weight loss.
Implications
- The amount of weight loss from pedometer-based walking programs is small but significant from a clinical perspective.
- Walking programs that use pedometers can have health benefits that are associated with both a modest weight loss and increased physical activity.
Annals Journal Club Selection
Jan/Feb 2008
The Annals Journal Club is designed to encourage a learning community of those seeking to improve health care and health through enhanced primary care. Additional information is available on the Journal Club home page.
The Annals of Family Medicine encourages readers to develop the learning community of those seeking to improve health care and health through enhanced primary care. You can participate by conducting a RADICAL journal club, and sharing the results of your discussions in the Annals online discussion for the featured articles. RADICAL is an acronym for: Read, Ask, Discuss, Inquire, Collaborate, Act, and Learn. The word radical also indicates the need to engage diverse participants in thinking critically about important issues affecting primary care, and then acting on those discussions.1Article for Discussion
- Richardson CR, Newton TL, Abraham JJ, Sen A, Jimbo M, Swartz AM. A Meta-Analysis of Pedometer-Based Walking Interventions and Weight Loss.Ann Fam Med. 2008;6:69-77.
Discussion Tips
The following article provides helpful background information on meta-analyses. It is available at http://www.bmj.com/cgi/content/full/315/7121/1533. Egger M. Meta-analysis: principles and procedures. BMJ.1997;315(6):1533-1537.Discussion Questions
- What questions are addressed by the article? Why do they matter?
- Is a meta-analysis a reasonable way to answer the research questions? Why?
- What are the main findings?
- To what degree can the findings be accounted for by:
- How studies were selected (inclusion criteria and search strategy)?
- How data were extracted from the parent studies for analysis?
- Limitations in the original studies or their reporting of key information?
- Confounding (false attribution of causality because 2 variables discovered to be associated actually are associated with a 3rd factor)?
- Publication bias (that is, positive studies being more likely to be published)?
- Chance?
Reference
- Stange KC, Miller WL, McLellan LA, et al. Annals journal club: It�s time to get RADICAL. Ann Fam Med. 2006;4:196-197. Available at: http://annfammed.org/cgi/content/full/4/3/196.
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