Step-Based Metrics and Overall Physical Activity in Children With Overweight or Obesity: Cross-Sectional Study

Jairo H Migueles, Cristina Cadenas-Sanchez, Elroy J Aguiar, Pablo Molina-Garcia, Patricio Solis-Urra, Jose Mora-Gonzalez, Eduardo García-Mármol, Eric J Shiroma, Idoia Labayen, Palma Chillón, Marie Löf, Catrine Tudor-Locke, Francisco B Ortega, Jairo H Migueles, Cristina Cadenas-Sanchez, Elroy J Aguiar, Pablo Molina-Garcia, Patricio Solis-Urra, Jose Mora-Gonzalez, Eduardo García-Mármol, Eric J Shiroma, Idoia Labayen, Palma Chillón, Marie Löf, Catrine Tudor-Locke, Francisco B Ortega

Abstract

Background: Best-practice early interventions to increase physical activity (PA) in children with overweight and 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-as a proportion of total PA level-is performed by children who are overweight and obese in order to determine its utility as a public health strategy.

Objective: This study aimed to (1) investigate the proportion of overall PA indicators that are explained by step-based metrics and (2) study step accumulation patterns relative to achievement of public health recommendations in children who are overweight and obese.

Methods: A total of 105 overweight and obese children (mean 10.1 years of age [SD 1.1]; 43 girls) wore hip-worn accelerometers for 7 days. PA volumes were derived using the daily average of counts per 15 seconds, categorized using standard cut points for light-moderate-vigorous PA (LMVPA) and moderate-to-vigorous PA (MVPA). Derived step-based metrics included volume (steps/day), time in cadence bands, and peak 1-minute, 30-minute, and 60-minute cadences.

Results: Steps per day explained 66%, 40%, and 74% of variance for counts per 15 seconds, LMVPA, and MVPA, respectively. The variance explained was increased up to 80%, 92%, and 77% by including specific cadence bands and peak cadences. Children meeting the World Health Organization recommendation of 60 minutes per day of MVPA spent less time at zero cadence and more time in cadence bands representing sporadic movement to brisk walking (ie, 20-119 steps/min) than their less-active peers.

Conclusions: Step-based metrics, including steps per day and various cadence-based metrics, seem to capture a large proportion of PA for children who are overweight and obese. Given the availability of pedometers, step-based metrics could be useful in discriminating between those children who do or do not achieve MVPA recommendations.

Trial registration: ClinicalTrials.gov NCT02295072; https://ichgcp.net/clinical-trials-registry/NCT02295072.

Keywords: MVPA; cadence; motion sensor; pedometer; sedentary behavior.

Conflict of interest statement

Conflicts of Interest: None declared.

©Jairo H Migueles, Cristina Cadenas-Sanchez, Elroy J Aguiar, Pablo Molina-Garcia, Patricio Solis-Urra, Jose Mora-Gonzalez, Eduardo García-Mármol, Eric J Shiroma, Idoia Labayen, Palma Chillón, Marie Löf, Catrine Tudor-Locke, Francisco B Ortega. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 28.04.2020.

Figures

Figure 1
Figure 1
Proportion of variance (r2) in overall physical activity indicators, which is explained independently by each step-based metric. LMVPA: light-moderate-vigorous physical activity; MVPA: moderate-to-vigorous physical activity.
Figure 2
Figure 2
Proportion of variance (r2) in overall physical activity (PA) indicators (ie, counts/15 sec, light-moderate-vigorous PA [LMVPA], and moderate-to-vigorous PA [MVPA]), which is explained by a combination of step-based metrics, calculated using stepwise linear regressions. All predictors presented variance inflation factors of <6 in the selected models.
Figure 3
Figure 3
Time spent in each cadence band (panel A) and peak cadences (panel B) across children meeting or not meeting the physical activity guidelines (ie, ≥60 minutes of MVPA/day). Error bars represent SDs. MVPA: moderate-to-vigorous physical activity.
Figure 4
Figure 4
Linear regression line, with 95% CI (shaded areas), for the association between moderate-to-vigorous physical activity (MVPA) and step-based metrics: step volume (panel A), cadence bands (panel B), and peak cadences (panel C). PA: physical activity.

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