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Effects of 10,000 steps a day on physical and mental health in overweight participants in a community setting: A preliminary study

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Background: Being overweight is associated not only with physical health problems, but also with risk of mental health problems. Increased physical activity (PA) has been recommended for the prevention of cardiovascular disease; however, little is known about the effect of walking on physical and mental health outcomes. Objective: The purpose of the study was to explore the effectiveness of a pedometer-based PA intervention on physical and mental health states. Method: Thirty-five overweight participants with body mass index (BMI) ≥25 kg•m-2 were selected and assigned to a 12-week pedometer-based walking program (10,000 steps•d-1). The profile of mood states, BMI, waist circumference (WC), body fat percentage (%BF), and lean body mass (LBM) were measured before and after the 12-week intervention. The number of step counts was recorded 5 days a week in a diary booklet. Results: The 30 participants who accumulated 10,000 steps•d-1 had significantly lower anxiety, depression, anger, fatigue, confusion, and total mood distress scores compared with measurements taken prior to the intervention. Further, the participants had higher vigor scores compared to baseline. Regarding physical health, the participants who accrued 10,000 steps a day had significantly lower body weight, WC, BMI, and %BP. After adjustment for gender, height, and daily steps at follow-up, changes in WC were negatively associated with depression, fatigue, confusion, and total mood distress. Conclusions: An increase in PA by accumulating at least 10,000 steps•d-1 over a 12-week period improves physical and mood states in sedentary, overweight individuals.
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http://dx.doi.org/10.1590/bjpt-rbf.2014.0160 1
Braz J Phys Ther.      
Effects of 10,000 steps a day on physical and mental
health in overweight participants in a community setting:
a preliminary study
Kornanong Yuenyongchaiwat1
ABSTRACT | Background: Being overweight is associated not only with physical health problems, but also with risk of
mental health problems. Increased physical activity (PA) has been recommended for the prevention of cardiovascular
disease; however, little is known about the effect of walking on physical and mental health outcomes. Objective: The
purpose of the study was to explore the effectiveness of a pedometer-based PA intervention on physical and mental
health states. Method: Thirty-ve overweight participants with body mass index (BMI) ≥25 kg•m–2 were selected and
assigned to a 12-week pedometer-based walking program (10,000 steps•d–1). The prole of mood states, BMI, waist
circumference (WC), body fat percentage (%BF), and lean body mass (LBM) were measured before and after the 12-week
intervention. The number of step counts was recorded 5 days a week in a diary booklet. Results: The 30 participants
who accumulated 10,000 steps•d–1 had signicantly lower anxiety, depression, anger, fatigue, confusion, and total mood
distress scores compared with measurements taken prior to the intervention. Further, the participants had higher vigor
scores compared to baseline. Regarding physical health, the participants who accrued 10,000 steps a day had signicantly
lower body weight, WC, BMI, and %BP. After adjustment for gender, height, and daily steps at follow-up, changes in
WC were negatively associated with depression, fatigue, confusion, and total mood distress. Conclusions: An increase
in PA by accumulating at least 10,000 steps•d–1 over a 12-week period improves physical and mood states in sedentary,
overweight individuals.
Keywords: physical activity; physical health; prole of mood states; overweight; walking; physical therapy.
Thai Clinical Trials Registry number: TCTR20151214002
BULLET POINTS
To explore the effect of 10,000 steps a day in sedentary, overweight Thai subjects.
10,000 steps a day may help to decrease physical and mental health problems.
They may also help to reduce risks of non-communicable disease and cardiovascular disease.
HOW TO CITE THIS ARTICLE
Yuenyongchaiwat K. Effects of 10,000 steps a day on physical and mental health in overweight participants in a community
setting: a preliminary study. Braz J Phys Ther.        http://dx.doi.org/10.1590/bjpt-rbf.2014.0160
1 Physiotherapy Department, Faculty of Allied Health Sciences, Thammasat University, Pathumthani, Thailand
Received: Aug. 06, 2015 Revised: Nov. 20, 2015 Accepted: Dec. 07, 2015
Introduction
Recently, overweight and obesity present major
health problems worldwide and these issues lead to
non-communicable diseases (NCDs) and cardiovascular
disease1,2. Further, evidence suggests that obesity is
associated with mental health problems (e.g. depression),
poor perceived health, low self-esteem, and body image
concern
3
. There is also evidence that obese individuals
can decrease mood disorders by controlling diet and
body weight, managing stress, improving self-esteem,
having psychological treatment, and exercising.
Physical activity (PA) has been consistently linked to
improved mood. In addition, there is strong evidence
that PA helps to decrease anxiety and depression
and improves mood, self-esteem, and body image4-6.
Regarding the relationship between obesity and PA,
several studies have shown that overweight/obesity
was inversely related to PA. For example, high body
mass index (BMI) and waist circumference (WC)
are related to decreased PA7,8. A recent systematic
review from 25 prospective cohort studies found that
PA levels including low PA (e.g. walking less than
150 minutes/week) could prevent future depression
9
.
Therefore, interventions to decrease mental and
Yuenyongchaiwat K
2Braz J Phys Ther.      
physical health problems by increasing PA should
be considered.
Recently, programs that increase the number of
daily walking steps have been promoted to improve
PA and a pedometer or step-counting device has been
commonly used to measure and promote PA. However,
little research has been conducted on the effects of
accumulating 10,000 steps with a pedometer on both
physical and mood states. Therefore, the aim of this
study was to determine the effect of 10,000 steps per
day with a pedometer on the prole of mood states
and physical health in overweight participants in a
community setting.
Method
Participants and design
Thirty-ve overweight adults aged 35-59 were
recruited (BMI≥25 kg•m–2). The ethics and protocol
were approved by the Ethics Committee of Thammasat
University, Pathumthani, Thailand (approval number
069/2557). All participants gave written informed
consent. The quasi-experimental study was designed
to determine whether the effect of a pedometer-based
intervention decreased mental and physical health
problems.
Measures and apparatus
Anthropometric measures, i.e. weight (kg),
height (cm), and WC, were assessed prior to and
after the intervention program. Evaluation of BMI
was used as an indicator of being overweight. WC
was measured at the level of the umbilicus. In
addition, percentage of body fat mass (%BF), lean
body mass (LBM; kg) were measured, which have
been described in detail elsewhere10.
All participants completed the Prole of Mood
States (POMS) scale11 to measure psychological
well-being at baseline and 12 weeks after baseline
assessment. The POMS is composed of 65 items
rated on a 5-point Likert scale. The checklist items
are comprised of 6 subscale scores: tension/anxiety,
depression, anger/hostility, fatigue, confusion, and
vigor. In addition, the total mood distress score
was used to evaluate an overall measure of mood
states. Subtraction of vigor scores from the sum of
the negative mood (i.e. tension, depression, anger,
fatigue, and confusion) was dened as the total
mood distress. The POMS has been found to have
good internal consistency of subscales, ranging
from 0.63 to 0.9611.
The number of walking steps per day was measured
at baseline with a pedometer (Yamax SW-200).
The participants were asked to wear their sealed
pedometer during the working day for 5 days whilst
following their normal daily routine and then record
the details in their booklet. During the 12-week
intervention, the participants were instructed to
walk at least 10,000 steps per day and record their
steps in their diary. At the end of week 12, body
weight, POMS, BMI, WC, WHR, %BF, and LBM
were assessed again.
Statistical analysis
Sample size calculations indicated that 30 participants
were needed to complete the study to ensure sufcient
power (80%) to detect an effect size (Cohen’s d=1.08).
In order to allow for attrition, 35 overweight participants
were recruited. Steps per day were calculated weekly
(i.e. 5 working days per week). The change in the
average number of steps per day over the 12-week
intervention program was modeled for each participant.
Descriptive data are presented as percentage (%),
mean, and standard deviation (SD). Data were veried
for normality of distribution (Kolmogorov-Smirnov
goodness-of-t test). Changes in physical health
outcomes were calculated by subtracting physical
health outcomes at follow-up from initial baseline
physical health values. The paired t-test was used to
determine whether the pedometer decreased signicant
changes in physical and mental health outcomes.
Pearson’s correlations coefcients were calculated
between POMS after a 12-week period and changed
physical health. To examine the association between
POMS and physical health outcomes after adjusting
for possible confounding variables (e.g. gender,
height, and daily walking steps at follow-up), partial
correlational analysis was conducted. In addition, a
regression analysis was performed to evaluate the
utility of the effects of the pedometer for improving
health outcomes in overweight participants. Multiple
regression analyses were conducted to determine
the unique contribution of 10,000 steps per day to
the improvement of mental health outcomes after
adjustment for initial POMS and daily walking steps. In
the linear regression, the assumptions of normality of
the residual scores were met. In addition, all analyses
were conducted with SPSS version 20.0 and the level
of statistical signicance was considered as p<0.05.
Physical activity and health outcomes
3
Braz J Phys Ther.      
Results
Changes in physical and mental health states
with the pedometer-based intervention
program
The mean age of the participants was 49.67±6.51 years.
A total of 30 participants (9 males and 21 females)
completed the walking program. Of the 5 participants
(14.29%) who did not complete the protocol,
one was pregnant and one had leg pain due to a
herniated disc caused by heavy lifting. Based on
the denition of PA by Tudor-Locke et al.12, the
participants were dened as a sedentary (i.e. less
than 5,000 steps a day) at baseline. As shown in
Table 1, feelings of tension, depression, anger,
confusion, fatigue, and total mood distress decreased
signicantly after the 12-week program, as did body
weight, BMI, WC, and %BF. In addition, vigor
scores increased signicantly (p<.05 in all cases).
In short, accumulating 10,000 steps a day resulted
in a signicant decrease in negative mood and
negative physical health outcomes and signicant
improvements in vigor-activity with a large effect
size (d≥.8 in all cases; Cohen13).
Correlations between daily walking steps,
profile mood states, and physical health
outcomes at follow-up
As seen in Table 2, the participants who accrued
10,000 steps a day had a modest but signicant inverse
correlation with decreased body weight, BMI, and WC
at 12 weeks. In addition, analysis of the correlation
revealed that changes in WC were negatively associated
with depression, fatigue, confusion, and total mood
distress (p<.05 in all cases). Further, negative association
was observed between %BF and anger state (p<.05;
see Table 3). Overall, there was a large (r>0.4 in all
cases, according to Cohen
13
) negative correlation
between health outcomes (e.g. WC) and prole of
mood states (e.g. depression).
To determine whether the relationship between
mental health states and physical health changes
survived adjustment, partial correlation analysis was
then computed adjusting for gender, height, and daily
walking steps at follow-up.
Partial correlations showed that the relationships
between changes in WC and depression, fatigue,
confusion, and total mood distress survived adjustment
for gender height and daily walking steps at follow-up.
Further, the relationship between %BF and anger
states also remained signicant after adjusting for
Table 1. Comparison between pre- and post-intervention programs in overweight participants.
Pre-intervention
Mean±SD
Post-intervention
Mean±SD Mean difference
95% condence
interval for the
difference
p-value
Walking (steps/day) 4,540.53±1,959.00 10,500.20±2070.54 –5,960.67 –6774.85 to -5145.49 <.001
BW (kg) 71.40±10.73 69.87±10.33 1.53 .54 to 2.52 .004
WC (cm) 92.63±9.26 90.33±8.16 2.30 .80 to 3.80 .004
WHR .88±.05 .89±.06 .01 –.01 to .03 .477
BMI (kg/m2)27.86±4.33 27.25±3.93 .62 .18 to 1.06 .007
BF (%) 32.97±6.89 29.82±7.29 3.15 2.19 to 4.12 <001
LBM (kg) 47.42±5.57 48.54±5.21 –1.12 –1.91 to -.34 .006
Prole of Mood State Scores
Tension/Anxiety 16.13±4.46 13.37±3.73 2.77 .92 to 4.61 .005
Depression 22.53±7.78 19.97±5.67 2.57 .59 to 4.54 .013
Anger 19.40±5.88 17.60±5.35 1.80 .57 to 3.03 .005
Fatigue 11.73±4.86 11.06±4.86 .67 .14 to 1.20 .016
Confusion 13.37±4.87 12.33 ± 4.10 1.03 .16 to 1.91 .022
Vigor 23.80±4.37 27.33±3.63 –3.53 –4.64 to -2.43 <.001
Total mood distress 59.37±24.83 47.10±16.41 12.27 7.95 to 16.59 <.001
BW: body weight; WC: waist circumference; WHR: waist-hip ratio; BMI: body mass index; BF: body fat; LBM: lean body mass.
Yuenyongchaiwat K
4Braz J Phys Ther.      
gender, height, and daily walking steps at follow-
up (see Table 4). In other words, lower WC was
still associated with lower depression, confusion,
and total mood distress scores, after controlling for
gender, height, and 10,000 steps a day. Moreover, the
participants who had higher %BF were associated with
higher anger states. In sum, the negative relationships
between physical health and prole of mood states
remained statistically signicant, albeit modest, after
controlling for gender, height, and 10,000 steps a day.
Prediction of longitudinal changes in mental
health problems over a 12 week later
In addition, the study examined whether the
contribution of walking steps•d–1 to the prediction of
follow-up mental health outcomes. As can be seen
in Table 5, future depression scores were related to
initial depression scores and daily walking steps
at follow-up (R2=.645, p<.001), and the more the
number of walking steps (≥10,000 steps per day) or PA
increased, the more the depression scores decreased.
Discussion
The present study evaluated the efficacy of
accumulating 10,000 steps per day on the mood
states and physical health outcomes of overweight
participants in a community setting. Further, these
participants were leading a sedentary lifestyle (<5,000
Table 3. Bivariate correlations between physical health changes and prole mood states after a 12-week period.
POMS Pearson correlation (r; p-value)
Δ BW Δ WC Δ WHR Δ BMI Δ %BF Δ LBM
Tension .01; .97 .06; .74 –.10; .61 .03; .86 .13; .51 –.12; .55
Depression –.02; .91 –.37; .05 .01; .94 .00; 1.00 .18; .35 –.19; .32
Anger .28; .14 –.32; .09 .16; .39 .27; .14 .43; .02 –.15; .44
Fatigue .08; .66 –.41; .02 .17; .38 .09; .64 .24; .19 –.11; .56
Confusion .08; .70 –.52; .00 .04; .85 .08; .67 .10; .62 –.02; .93
Vigor .04; .85 –.24; .20 –.15; .42 .03; .88 .08; .67 –.04; .82
TMD .12; .54 –.42; .02 .13; .51 .14; .48 .31; .10 –.17; .38
Δ: changes; POMS: prole of mood states; BW: body weight; WC: waist circumference; WHR: waist-hip ratio; BMI: body mass index; BF: body
fat; LBM: lean body mass; TMD: total mood distress.
Table 2. Bivariate correlation between daily walking steps and
physical health at the 12-week follow-up.
Physical health
outcomes
Daily walking steps at follow-up
Pearson
correlation (r)p-value
BW –.46 .01
BMI –.42 .02
WC –45 .01
WHR –.26 .16
%BF –.30 .11
LBM –.29 .12
BW: body weight; BMI: Body mass index; WC: waist circumference;
WHR: waist-hip ratio; BF: body fat; LBM: lean body mass.
Table 4. Partial correlations between psychological well-being and physical health changes controlling for height, gender, and daily
walking steps at follow-up among overweight participants.
POMS Pearson correlation (r; p-value)
Δ BW Δ WC Δ WHR Δ BMI Δ %BF Δ LBM
Tension –.02; .94 .124; .54 –.049; .81 .01; .97 .05; .80 –.09; .64
Depression .00; .99 –.449; .02 .035; .86 .03; .90 .18; .38 –.16; .41
Anger .29; .15 –.302; .13 .200; .32 .28; .15 .45; .02 –.14; .47
Fatigue .11; .58 –.407; .04 .193; .34 .12; .55 .29; .14 –.12; .56
Confusion .11; 58 –.558; .00 .001; 1.00 .13; .53 .21; .29 –.06; .77
Vigor .06; .77 –.203; .31 –.144; .47 .06; .78 .12; .55 –.06; .77
TMD .13; .51 –.437; .02 .149; .46 .15; .45 .32; .10 –.16; .43
Δ: changes; POMS: prole of mood states; BW: body weight; WC: waist circumference; WHR: waist-hip ratio; BMI: body mass index;
TMD: total mood distress; BF: body fat; LBM: lean body mass.
Physical activity and health outcomes
5
Braz J Phys Ther.      
steps per day)
12
. The main ndings of the present study
were that participants displayed decreased negative
mood (i.e. anxiety, depression, anger, confusion,
and total mood distress scores), body weight, BMI,
WC, and %BF after increasing PA by accumulating
≥10,000 steps daily using the pedometer in a 12-week
walking intervention. In addition, the results found that
walking 10,000 steps a day played a role in decreasing
depression scores after controlling for gender, height,
initial depression scores, initial daily walking steps,
and changes in daily walking steps.
The results conrm recent ndings indicating that
walking 10,000 steps per day is effective in increasing
PA. In particular, a meta-analysis of 26 studies from
1966 to 2007 suggested that using a pedometer
increased PA
14
. Further, the benecial change in
weight demonstrated in the current study agrees with
other studies, which showed that 10,000 steps per day
resulted in a signicant decrease in body weight, BMI,
%BF, and WC15-17. Further, Tudor-Locke18 described
pedometer-based guidelines and cardiovascular health
outcomes and concluded that increasing walking
steps can improve BMI and cardiovascular health
outcomes
18
. Thus, accumulating at least 10,000 steps
per day may account, in part, for a reduction in WC
and BMI.
In addition, the present study results indicate that
walking 10,000 steps per day is effective in reducing
negative mood states. Previous studies have also
demonstrated positive effects following a walking
intervention. Several systematic reviews have shown
the effect of exercise (e.g. aerobic exercise, walking)
on PA on emotional states (i.e. depression, anxiety, and
mood)
4,9,19-21
. These reviews revealed that exercise/PA
is related to decreased anxiety, depression, and mood
states as well as improved psychological well-being.
In the present study, the benets of accumulating
10,000 steps a day over a 12-week period were
supported by the self-reported results of the POMS:
decreased tension, depression, anger, confusion,
fatigue, and total mood distress. Moreover, increased
vitality was observed in the participants who attained
10,000 steps a day.
It has been known that the effects of exercise
reduce stress; however, few studies have reported the
accumulation of 10,000 steps a day specically22,23.
The American College of Sports Medicine (ACSM)
and the American Heart Association (AHA) have
recommended individual accumulations of at least
30 minutes of moderate-intensity PA (e.g. brisk
walking) 5 days per week or 150 minutes per week
for all population groups
24
. Other studies have shown
that accumulating at least 10,000 steps•d
–1
meets that
minimum requirement12,25. Therefore, a daily target
of 10,000 steps has been generally suggested to
improve health outcomes in sedentary lifestyle and
promote a decrease in negative mood (e.g. anxiety
and depression).
With respect to POMS and physical outcomes, our
results indicate that participants with decreased WC
exhibited less depression, fatigue, confusion, and total
mood distress scores after a 12-week intervention. In
addition, the relationships between WC and negative
mood disorders (i.e. depression, confusion, and
total mood distress) were maintained after statistical
adjustment for baseline walking steps, increased
steps walk, gender, and age. Moreover, increasing
steps daily (accumulating up to 10,000 steps a day)
predicted future depression scores after controlling for
initial depression scores and baseline daily walking
steps. Therefore, the present study would suggest
that one mechanism linking negative mood disorders
with the 10,000 steps a day may involve changed
physical outcome (i.e. decreased WC). In addition,
WC is assumed to be a risk factor for obesity and an
indicator for cardiovascular risk (e.g. type 2 diabetes,
hypertension, cardiovascular disease)
2
. In a large
survey with U.S. adults, Zhao et al.26 reported that WC
is related to increased risk of depressive symptoms.
Hence, the present study provides some supporting
evidence for the involvement of 10,000 daily steps
in participants with negative mood: they showed a
decreased WC.
It should be noted that this study has a few limitations
that may have affected the results. The absence of
a control group is the most important limitation;
Table 5. Multiple regression analysis effect of 10,000 steps per day on depression from baseline characteristics.
Non-standardized
coefcients (B)
Standardized
Coefcients (β) p-value 95% Condence
interval for B
Baseline depression scores .54 .74 <.001 .36 to .72
Initial daily walking steps –.00 –.32 .030 .00 to .00
Changed daily walking steps –.00 –.31 .036 .00 to .00
Yuenyongchaiwat K
6Braz J Phys Ther.      
therefore, the effects observed are overestimated,
given that important confounders (i.e. placebo effects,
polite patients, regression to the mean, recall bias, and
natural history) were not controlled. Therefore, a high
quality randomized controlled trial is strongly needed
to conrm our results. The study had a relatively small
sample size and most of the participants recruited
were females (70%). Therefore, results cannot be
used to draw conclusions for the whole population.
In summary, the use of a pedometer can improve
PA, and the effect of walking with the goal of
accumulating 10,000 steps per day results in improved
POMS scores (i.e. decreased tension, depression,
anger, fatigue, confusion, and total mood distress)
as well as improved vigor in overweight adults with
sedentary lifestyle.
Acknowledgements
The author acknowledges the help of Mr. Paitoon
Dhari, head of the community health service, and
Mrs. Somsong Duren, registered nurse, for organizing
and overseeing participant recruitment in the community.
The study is also thankful to Pantip Sukprasert for
her assistance in completing this study. Lastly, the
author would like to thank the participants in the
community for their participation. This study was
fully supported by a research grant from Thammasat
University No. 19/2557.
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Correspondence
Kornanong Yuenyongchaiwat
Thammasat University
Faculty of Allied Health Sciences
Physiotherapy Department
99 Moo 18, Paholyothin Road, Klong Luang, Rangsit
Prathumthani, 12120, Thailand
e-mail: ykornano@tu.ac.th, plekornanong@gmail.com
... In this context, taking at least 10,000 steps per day of Sports Science students during the pandemic period increased their mental well-being, but the fact that this increase was not statistically significant can be because the basic psychological status and needs of the students were not fulfilled. In studies conducted before the pandemic, it was reported that walking exercises based on taking at least 10,000 steps per day for 12 weeks reduced the WHR values of the participants (Yuenyongchaiwat, 2016;Göçer, 2015). Again, in a study conducted on university students before the pandemic, it was observed that although there was a significant increase in the number of daily steps in the experimental group compared to the control group, there was no change in health data (Rote, 2017). ...
... In another study, it was observed that an internet-based motivational intervention supported by pedometers significantly increased the number of steps of sedentary students (Miragall et al. 2018). In another study, it was concluded that after 12 weeks of walking exercise applied to participants who took (<5,000) steps per day, participants took at least 10,000 steps per day, resulting in an increase in the physical activity level of the participants, and a decrease in body weight and BMI values (Yuenyongchaiwat, 2016). In a study conducted before the pandemic; as a result of asking participants to take more steps gradually over 24 weeks; It has been reported that taking at least 10,000 steps per day has a positive effect on the body weight and body composition of individuals (Bailey et al., 2019). ...
Article
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This study aims to determine whether the number of daily steps is effective in the body composition and mental well-being of university students during the COVID-19 pandemic. The research group of the study consisted of 40 volunteer students studying at the Faculty of Sport Sciences by being randomly assigned to the experimental (n:20) and control (n:20) groups. The research is in the experimental model with a pre-test/post-test control group. As a data collection tool in the study, the 'Warwick-Edinburgh Mental Well-Being Scale' was used to determine the personal information form and mental well-being. The obtained data were analysed in the Jamovi 1.8.2 statistical software program with a 95% reliability interval and 5% margin of error. In the analysis of the data, percentage (%), frequency (f), and mean (x̄) values were used in the descriptive data, Paired Samples t-test was used in the pre-test/post-test comparison, and Multinomial Regression analysis was used in the relational analysis. According to the findings of the study, 75% of the students in the experimental group and 70% of the students in the control group were in the normal weight class according to the body mass index classification. According to waist-hip ratio classification, 85% of the experimental group and 70% of the control group were in the group that did not have cardiovascular disease risk. After two months of application, the daily average number of steps of the experimental group (12.5751898.1) and the daily average number of steps of the control group were determined as (5381.272026.2). While there was a statistically significant difference in the pre-test/post-test body mass index averages of the experimental group who were asked to take at least 10,000 steps per day (p0.05), although there was an increase in the mean waist-hip ratio and mental well-being, there was no statistically significant difference (p0.05). It was determined that the step average had a statistically significant effect on the experimental group according to the body mass index classification (p0.05). As a result, while taking at least 10,000 steps per day was effective in the body mass index of the students, it was not so in the waist-hip ratio and mental well-being. In this context, physical activity, and especially walking, can be recommended at the point of protecting health. Article visualizations: </p
... On the other hand, physical activity has been considered preventive and mitigatory for depression (Choi et al., 2020;Reichert et al., 2011) and anxiety (Yuenyongchaiwat, 2016). Subjects that at least maintained their regular fitness level during the pandemic presented with fewer symptoms of depression and anxiety. ...
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Multimorbidity is a global health issue impacting the quality of life of all ages. Multimorbidity with a mental disorder is little studied and is likely to have been affected by the COVID-19 pandemic. We used a survey of 14,007 respondents living in Brazil to investigate whether people who already had at least one chronic medical condition had more depression and anxiety symptoms during social distancing in 2020. Generalized linear models and structural equation modelling were used to estimate the effects. A 19 % and 15 % increase in depressive symptoms were found in females and males, respectively, for each unit of increase in the observed value of reported chronic disease. Older subjects presented fewer symptoms of depression and anxiety. There was a 16 % increase in anxiety symptoms in females for each unit increase in the reported chronic disease variable and a 14 % increase in males. Younger subjects were more affected by anxiety symptoms in a dose-response fashion. High income was significantly related to fewer depressive and anxiety symptoms in both males and females. Physical activity was significantly associated with fewer anxiety and depression symptoms. Structural equation modelling confirmed these results and provided further insight into the hypothesised paths.
... 37,38 However, a slight increase in physical activity and number of steps can decrease weight, BMI, and blood pressure, and psychiatric problems and prevent cardiovascular disease. 39 Especially in people with long sedentary times, physical activity and health status have a significant linear relationship. 40 An increase in water intake has been proven to decrease hypertension. ...
Article
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Introduction Adequate water intake is a low-cost and effectively non-invasive strategy for individual health outcomes. We aimed to demonstrate the efficacy of water intake intervention in intensive-labor and static-type workplaces. Method Smart drinking cups were provided to the participants, and a built-in application (App) associated with the cup was downloaded on their phones. The App collected and recorded the amount of drinking water consumed by the participants set reminders for drinking water and drinking water health education information. We assessed the data, including the amount of and time interval between water intake, sedentary time, the degree of physical and psychological importance of oneself, self-satisfaction, and physical fitness. Results After the intervention, water intake in the two companies significantly increased during the reminder period compared with the non-reminder period. A significant increase was noted in week 3 in the amount of water intake by the participants after using the App, and the total sedentary time considerably decreased. Furthermore, the interval between water consumption decreased compared with the preintervention interval. The systolic and diastolic blood pressure decreased in the participants working at the static-type and intensive-labor workplaces after the intervention, respectively. The participants ' lower limb muscle performance also improved significantly, and the emphasis on self-care was significantly improved. Conclusions The health-promoting effects of the water intake wellness intervention were akin to the butterfly effect. Besides significantly increasing water intake, the intervention improved other health behaviors, thereby benefiting physical and mental health. Hence, promoting water consumption in workplaces till it becomes a habit may benefit the employees.
... Larger daily step counts have been shown to be correlated with lower depression, anger, and mood distress in previous studies. [39] • Total Distance Moved: We calculate the daily total distance traveled by each participant. ...
... Second, our PA intervention did not result in the needed step increase that would have enabled us to effectively test our between-group hypotheses. This manipulation failure may have been because of high preintervention steps for the PA group, which had a baseline mean step count of 9942 (SD 4841), only a few steps away from the 10,000-step goal typically given in PA interventions (ie, a ceiling effect) [77]. The CBT-i Coach app also includes some recommendations for engaging in regular exercise. ...
Article
Background Insomnia is a prevalent and debilitating disorder among veterans. Cognitive behavioral therapy for insomnia (CBTI) can be effective for treating insomnia, although many cannot access this care. Technology-based solutions and lifestyle changes, such as physical activity (PA), offer affordable and accessible self-management alternatives to in-person CBTI. Objective This study aims to extend and replicate prior pilot work to examine whether the use of a mobile app for CBTI (cognitive behavioral therapy for insomnia coach app [CBT-i Coach]) improves subjective and objective sleep outcomes. This study also aims to investigate whether the use of the CBT-i Coach app with adjunctive PA improves sleep outcomes more than CBT-i Coach alone. Methods A total of 33 veterans (mean age 37.61 years, SD 9.35 years) reporting chronic insomnia were randomized to use either the CBT-i Coach app alone or the CBT-i Coach app with a PA intervention over 6 weeks, with outcome measures of objective and subjective sleep at pre- and posttreatment. Results Although the PA manipulation was unsuccessful, both groups of veterans using the CBT-i Coach app showed significant improvement from baseline to postintervention on insomnia (P<.001), sleep quality (P<.001), and functional sleep outcomes (P=.002). Improvements in subjective sleep outcomes were similar in those with and without posttraumatic stress disorder and mild-to-moderate sleep apnea. We also observed a significant but modest increase in objective sleep efficiency (P=.02). Conclusions These findings suggest that the use of a mobile app–delivered CBTI is feasible and beneficial for improving sleep outcomes in veterans with insomnia, including those with comorbid conditions such as posttraumatic stress disorder or mild-to-moderate sleep apnea. Trial Registration ClinicalTrials.gov NCT03305354; https://clinicaltrials.gov/ct2/show/NCT03305354
... Excess weight refers to an excessive accumulation of body fat, generally caused by a sedentary lifestyle [43] and poor eating habits [6]. This condition reduces the duration and quality of life, favouring the onset and aggravation of numerous pathologies, and is a more frequent characteristic with increasing age, among males, among people with economic difficulties, and among those with a low level of education [4,30,42]. ...
Article
Full-text available
This article presents an evaluation of the “Friuli Venezia Giulia in Movimento” project, aimed at promoting the culture of movement and well-being in a region which is particularly affected by population ageing. The goals of the project reside in promoting appropriate lifestyles through the endorsement of healthy behaviours (physical activity, healthy nutrition, well-being); increasing the number of physically active people in the various municipal territories, by enhancing or creating new pedestrian paths that reflect the 10,000-step goal; enhancing the local territory by promoting the existing paths and the initiatives already in place; promoting new paths and environments conducive to physical activity for people of all ages; encouraging the creation of new “walking groups” and the adhesion of people to them to promote physical activity and socialisation, with the consequent improvement of psychophysical well-being. Although the evaluation is still on-going, the preliminary results—obtained by means of two surveys and a multilevel model—show that the initial steps of the project have been carried out satisfactorily and that Municipalities still need to be supported in order to achieve good participation on part of the citizens.
... Obesity is a medical condition that affects millions of people globally; it is a serious health issue in the 21st century [1]. Obesity is the body fat accumulation that adversely affects physical and mental health [2]. Many studies confirm the link between obesity, premature death, metabolic syndrome, cardiovascular disease, and mobility disorders [3][4][5]. ...
Article
During pandemics, effective interventions require monitoring the problem at different scales and understanding the various trade-offs between efficacy, privacy, and economic burden. To address these challenges, we propose a framework where we perform Bayesian change-point analysis on aggregate behavior markers extracted from mobile sensing data collected during the COVID-19 pandemic. Results generated by 598 participants for up to 4 months reveal rich insights: We observe an increase in smartphone usage around February 10th, followed by an increase in email usage around February 27th and, finally, a large reduction in participant’s mobility around March 13th. These behavior changes overlapped with important news events and government directives such as the naming of COVID-19, a spike in the number of reported cases in Europe, and the declaration of national emergency by President Trump. We also show that our detected change points align with changes in large scale external sources, including number of COVID-19 tweets, COVID-19 search traffic, and a large scale foot traffic data collected by Safegraph, providing further validation of our method. Our results show promise towards the feasibility of using mobile sensing to understand communities’ responses to public health interventions.
Article
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The measures to fight the spread of the COVID-19 pandemic have been concentrated on inviting people to stay at home. This has reduced opportunities to exercise while also shedding some light on the importance of physical health. Based on an online survey, this paper investigated physical activity behaviours of a Belgians sample (n = 427) during the lockdown period between the end of May 2020 and the beginning of June 2020 and found that, during this period, the gap between sufficiently and insufficiently active individuals widened even more. This paper analysed important moderators of physical activity behaviours, such as barriers and benefits to exercise, digital support used to exercise, and individuals’ emotional well-being. Descriptive analysis and analyses of variance indicated that, generally, individuals significantly increased their engagement in exercise, especially light- and moderate-intensity activities, mostly accepted the listed benefits but refused the listed barriers, increased their engagement in digital support and did not score high on any affective measures. A comparison between sufficiently active and insufficiently active individuals during the lockdown showed that the former engaged even more in physical activity, whereas the latter exercised equally (i.e., not enough) or even less compared to before the lockdown. By means of a logistic regression, five key factors of belonging to the sufficiently active group were revealed and discussed. Practical implications for government and policies are reviewed.
Article
Physical inactivity is one of the major contributing factors to the global pandemic of non-communicable diseases. Unfortunately, low levels of habitual movement and physical activity (PA) are seen in an increasing proportion of populations across low- and middle-income countries and high-income countries alike. This new normal – the inactive phenotype – is a significant contributor to multiple health and economic costs. Here we provide a brief historical overview of societal declines in PA, roughly consistent with major transitions in PA and nutrition in recent decades. This is followed by a synthesis of research evidence linking inactivity with poor health outcomes and prevention approaches needed to impact a perpetuation of poor lifestyle behaviors. A major focus of the paper is on the economic/health costs and the reduction of the inactive phenotype. In summary, we demonstrate that the consequences of insufficient PA are manifold, and if sustained, impact short and long-term health and quality of life, along with substantial economic costs.
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In 1995 the American College of Sports Medicine and the Centers for Disease Control and Prevention published national guidelines on Physical Activity and Public Health. The Committee on Exercise and Cardiac Rehabilitation of the American Heart Association endorsed and supported these recommendations. The purpose of the present report is to update and clarify the 1995 recommendations on the types and amounts of physical activity needed by healthy adults to improve and maintain health. Development of this document was by an expert panel of scientists, including physicians, epidemiologists, exercise scientists, and public health specialists. This panel reviewed advances in pertinent physiologic, epidemiologic, and clinical scientific data, including primary research articles and reviews published since the original recommendation was issued in 1995. Issues considered by the panel included new scientific evidence relating physical activity to health, physical activity recommendations by various organizations in the interim, and communications issues. Key points related to updating the physical activity recommendation were outlined and writing groups were formed. A draft manuscript was prepared and circulated for review to the expert panel as well as to outside experts. Comments were integrated into the final recommendation. Primary recommendation: To promote and maintain health, all healthy adults aged 18 to 65 yr need moderate-intensity aerobic (endurance) physical activity for a minimum of 30 min on five days each week or vigorous-intensity aerobic physical activity for a minimum of 20 min on three days each week. [I (A)] Combinations of moderate- and vigorous-intensity activity can be performed to meet this recommendation. [IIa (B)] For example, a person can meet the recommendation by walking briskly for 30 min twice during the week and then jogging for 20 min on two other days. Moderate-intensity aerobic activity, which is generally equivalent to a brisk walk and noticeably accelerates the heart rate, can be accumulated toward the 30-min minimum by performing bouts each lasting 10 or more minutes. [I (B)] Vigorous-intensity activity is exemplified by jogging, and causes rapid breathing and a substantial increase in heart rate. In addition, every adult should perform activities that maintain or increase muscular strength and endurance a minimum of two days each week. [IIa (A)] Because of the dose-response relation between physical activity and health, persons who wish to further improve their personal fitness, reduce their risk for chronic diseases and disabilities or prevent unhealthy weight gain may benefit by exceeding the minimum recommended amounts of physical activity. [I (A)]
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Given its high prevalence and impact on quality of life, more research is needed in identifying factors that may prevent depression. This review examined whether physical activity (PA) is protective against the onset of depression. A comprehensive search was conducted up until December 2012 in the following databases: MEDLINE, Embase, PubMed, PsycINFO, SPORTDiscus, and Cochrane Database of Systematic Reviews. Data were analyzed between July 2012 and February 2013. Articles were chosen for the review if the study used a prospective-based, longitudinal design and examined relationships between PA and depression over at least two time intervals. A formal quality assessment for each study also was conducted independently by the two reviewers. The initial search yielded a total of 6363 citations. After a thorough selection process, 30 studies were included for analyses. Among these, 25 studies demonstrated that baseline PA was negatively associated with a risk of subsequent depression. The majority of these studies were of high methodologic quality, providing consistent evidence that PA may prevent future depression. There is promising evidence that any level of PA, including low levels (e.g., walking <150 minutes/weeks), can prevent future depression. From a population health perspective, promoting PA may serve as a valuable mental health promotion strategy in reducing the risk of developing depression.
Article
Background The metabolic syndrome is an important cluster of coronary heart disease risk factors with common insulin resistance. The extent to which the metabolic syndrome is associated with demographic and potentially modifiable lifestyle factors in the US population is unknown.Methods Metabolic syndrome–associated factors and prevalence, as defined by Adult Treatment Panel III criteria, were evaluated in a representative US sample of 3305 black, 3477 Mexican American, and 5581 white men and nonpregnant or lactating women aged 20 years and older who participated in the cross-sectional Third National Health and Nutrition Examination Survey.Results The metabolic syndrome was present in 22.8% and 22.6% of US men and women, respectively (P = .86). The age-specific prevalence was highest in Mexican Americans and lowest in blacks of both sexes. Ethnic differences persisted even after adjusting for age, body mass index, and socioeconomic status. The metabolic syndrome was present in 4.6%, 22.4%, and 59.6% of normal-weight, overweight, and obese men, respectively, and a similar distribution was observed in women. Older age, postmenopausal status, Mexican American ethnicity, higher body mass index, current smoking, low household income, high carbohydrate intake, no alcohol consumption, and physical inactivity were associated with increased odds of the metabolic syndrome.Conclusions The metabolic syndrome is present in more than 20% of the US adult population; varies substantially by ethnicity even after adjusting for body mass index, age, socioeconomic status, and other predictor variables; and is associated with several potentially modifiable lifestyle factors. Identification and clinical management of this high-risk group is an important aspect of coronary heart disease prevention.
Article
ProblemDepression is a common disorder worldwide. Most patients are treated within primary care and antidepressant treatment is not recommended for people with mild depression. Physical activity has been shown to alleviate depression but it is not known whether the less vigorous activity of walking – a potentially widely acceptable and safe intervention – confers such benefit.Method Eleven databases were systematically searched for randomised, controlled trials of walking as a treatment intervention for depression, from database inception until January 2012. Meta-analyses were carried out on all trials eligible for inclusion and on sub-groups of outdoor, indoor and group walking.ResultsOf the 14,672 articles retrieved, eight trials met the inclusion criteria. The pooled standardised mean difference (effect size) was −0.86 [−1.12, −0.61] showing that walking has a statistically significant, large effect on symptoms of depression. However, there was considerable heterogeneity amongst the interventions and research populations and it is uncertain whether the results can be generalised to specific populations such as primary care patients.Conclusions Walking has a statistically significant, large effect on the symptoms of depression in some populations, but the current evidence base from randomised, controlled trials is limited. Thus, while walking is a promising treatment for depression or depressive symptoms with few, if any, contraindications, further investigations to establish the frequency, intensity, duration and type(s) of effective walking interventions particularly in primary care populations would be beneficial for providing further recommendations to clinical practitioners.