This week's post is a guest article by my wife, KP, who delved into the scientific research that has been conducted on the humble pedometer. It certainly helped me lose weight, but can it improve all of our health?
The Dependent on Gadgets household has collectively lost four and a half stone since January 2012, using the formula of fewer calories in and more calories out. As my husband, JamesP, has written in his previous blog posts about his weight loss, this has been assisted by a lot of walking and a little technology, including using an internet app to count calories in and a pedometer to count our walking steps and calories out.
Pedometers can help people self-monitor their daily physical activity and raise their awareness of how much they actually do. We found it motivating and interesting to see how many steps we could accumulate over the day, by our walks and other activities, even the supermarket shop! (1,000 steps, by the way, for a shop around a moderate sized supermarket.) But we wondered, can a simple pedometer really help people increase their physical activity, lose weight and improve their health? I decided to look at some of the research evidence, and the answer is: yes, to some extent. So what are the key findings from the research?
Pedometers can motivate people to be more active, typically increasing steps by 2,000 a day
The evidence suggests that pedometers can indeed be a good motivational tool for helping people to increase their daily activity, at least to some degree. Minsoo Kang at Middle Tennessee State University and colleagues reviewed 32 research studies in which pedometers had been used in interventions as a way of motivating people to be more active. When they combined the results from all the studies, they found that using a pedometer increased people’s steps by, on average, 2,000 per day. That’s the equivalent of walking around an extra mile. In a different review, Caroline Richardson at the University of Michigan Medical School and colleagues examined research studies in which sedentary, overweight and obese people had been given a pedometer as part of a walking intervention. The review showed that, on average, the participants in these studies increased their steps by between 1,827 and 4,556 per day, depending on the study. By the end of the walking interventions, the participants were, on average, achieving between 7,296 and 10,480 steps a day (again, depending on the study), which is close to the 10,000 step goal that is commonly touted for achieving health benefits.
It’s important to have a goal
What the reviews show, though, is that it may be important to have a goal, like aiming for 10,000 steps a day. The review by Minsoo Kang and colleagues found that the interventions that had given participants the goal of achieving 10,000 steps a day resulted in the largest increases in physical activity. Dena Bravata at Stanford University and colleagues in another review also found that the 10,000 steps a day goal resulted in the largest increases in physical activity in the studies they examined. In the three studies where participants were given no goal, the participants did not significantly increase their activity.
It might take time and effort to lose weight and gain physical health benefits
Whilst wearing a pedometer can motivate people to increase their physical activity to some degree, studies have found only modest benefits for physical health. The authors of the review which combined findings from studies in which pedometers were used as part of walking interventions with sedentary, overweight and obese people found that the participants lost on average 1.27 kilograms (nearly three pounds) by the end of the programmes. This could be considered a low amount. However, there are two things to consider here. One is that the interventions aimed to help the participants to lose weight through walking only, and did not provide any dietary intervention, which, if they had, might have led to greater weight loss than walking alone. The other is that it may take time to lose weight. The length of these interventions ranged from four weeks to one year and, in general, the longer the intervention was, the greater the weight loss. For example, across the different studies, participants lost on average between 0.5 kilograms (around 1lb) and 3.7 kilograms (around 8lbs), with the loss of 3.7 kilograms being achieved in a study in which overweight men used their pedometers for a year.
Similarly, benefits for other aspects of health may take a bit more time and effort. Graham Baker at the University of Strathclyde and colleagues conducted a study of a 12-week, community-based walking intervention, in which people who were not meeting public health guidelines for physical activity were given a pedometer to help increase their activity. They found that while the people using pedometers increased their step counts and physical activity (from, on average, 6,802 per day before the intervention to, on average, 9,977 per day at the end of the intervention), there was no change in their blood pressure or cholesterol levels. The authors suggested that this may be because the programme built up people's activity slowly over the 12 weeks. The participants were initially instructed to do an extra 1,500 steps of brisk walking (that is, walking that makes you breathe harder, but during which you are still able to hold a conversation) on at least three days of the week. This then increased to the final goal of an extra 3,000 steps of brisk walking on at least five days of the week, given to participants during week 7 and which participants were told to maintain until week 12. Therefore, the participants only engaged in this higher amount and intensity of activity for the last six weeks of the intervention. The authors suggested that people may need to do this level of activity over a longer period of time than this for health changes to take place.
But it might make you feel good
Whilst people are waiting for some physical health benefits, though, they can take heart that their extra steps might at least make them feel better. In addition to its physical health benefits, there is evidence that physical activity can help improve your mood and mental health, including reducing feelings of depression. And research shows that you do not necessarily have to do types of activity that require a lot of physical effort, like running or playing sports, to gain benefits for your mental health. Researchers have found that even walking can help improve your mood. Indeed, Graham Baker and colleagues found that by the end of the 12-week community-based walking programme, the people who had been given a pedometer and increased their activity experienced a small to moderate improvement in their mood. Walking can also help more serious mood problems, like depression. A review of studies by Roma Robertson at the University of Stirling and colleagues, showed that walking can reduce depression. And they found that it reduced depression to a similar extent as had been found in reviews that had incorporated studies examining all kinds of physical activity.
So what are the messages from the research?
Well, in summary, wearing a pedometer might be a good motivational tool for some people for increasing the number of steps they take each day. But to lose weight or gain health benefits, it might take a little patience, as better results may be achieved by using pedometers over longer periods of time. But in the meantime people might feel better from becoming more active. And, finally, it’s important to have a goal, like aiming for 10,000 steps a day or whatever people feel is achievable for them.
Of course, research studies present averaged answers across averaged participants and do not tell the whole story for a particular individual. Although these studies show perhaps modest health benefits from using a pedometer, if you are considering buying or trying a pedometer, ultimately your own experience will tell you whether using one works for you.
For information about healthy weight loss and increasing your physical activity, see the (UK) NHS Choices website. Information about the current UK public health guidelines on the amount of physical activity you need to do for physical health benefits is available here. If you have a medical condition or any concerns about your health, talk to your doctor before increasing your physical activity or dieting.
List of the research articles referred to in this post:
Baker, G., Gray, S.R., Wright, A., Fitzsimons, C., Nimmo, M., Lowry, R., Mutrie, N., for the Scottish Physical Activity Research Collaboration (SPARColl). (2008). The effect of a pedometer-based community walking intervention “Walking for Wellbeing in the West” on physical activity levels and health outcomes: a 12-week randomized controlled trial. International Journal of Behavioural Nutrition and Physical Activity, 5: 44.
Bravata, D.M., Smith-Spangler, C., Sundaram, V., Gienger, A.L., Lin, N., Lewis, R., Stave, C.D., Olkin, I., Sirard, J.R. (2007). Using pedometers to increase physical activity and improve health: a systematic review. JAMA, 21, 2296-2304.
Ekkekakis, P., Backhouse, S.H., Gray, C., & Lind, E. (2008). Walking is popular among adults but is it pleasant? A framework for clarifying the link between walking and affect as illustrated in two studies. Psychology of Sport and Exercise, 9, 246-264.
Kang, M., Marshall, S.J., Barreira, T.V., & Lee, J.-O. (2009). Effect of pedometer-based physical activity interventions: a meta-analysis. Research Quarterly for Exercise and Sport, 80, 648-655.
Reed, J. & Ones, D. (2006). The effect of acute aerobic exercise on positively activated affect: A meta-analysis. Psychology of Sport and Exercise, 7, 477 – 514.
Richardson, C.R., Newton, T.L., Abraham, J.J., Sen, A., Jimbo, M., & Swartz, A.M. (2008). A meta-analysis of pedometer-based walking interventions and weight loss. Annals of Family Medicine, 6, 69-77.
Rimer, J., Dwan, K., Lawlor, D.A., Greig C.A., McMurdo, M., Morley, W., & Mead, G.E. (2012). Exercise for depression. Cochrane Database of Systematic Reviews, Issue 7. Art. No.: CD004366. DOI: 10.1002/14651858.CD004366.pub5.
Robertson, R., Robertson, A., Jepson, R., & Maxwell, M. (2012). Walking for depression or depressive symptoms: a systematic review and meta-analysis. Mental Health and Physical Activity, 5, 66-75.