Pattern of Daily Steps is Associated with Weight Loss: Secondary Analysis from the Step-Up Randomized Trial

Objective: The aim of this study was to examine the association between the amount, intensity, and pattern of steps·day^-1 with weight loss.

Methods: Participants (N = 260; age = 42.8 ± 8.9 y; BMI = 32.8 ± 3.5 kg/m² ) completed an 18-month weight-loss intervention that included a calorie-restricted diet and prescribed physical activity. Participants were categorized by 18-month weight loss as weight gain (GAIN), weight loss of 0% to < 5% (WL < 5%), 5% to < 10% (WL < 10%), or ≥ 10% (WL ≥ 10%). Steps·day^-1 were measured at 0, 6, 12, and 18 months and defined as total steps·day^-1 , total steps·day^-1 of moderate-to-vigorous physical activity (MVPA) (≥3 metabolic equivalents) in bouts of ≥ 10 minutes (BOUT-MVPA), MVPA in bouts of < 10 minutes (NON-BOUT-MVPA), or non-MVPA steps·day^-1 (NON-MVPA).

Results: There was a weight-loss category by time interaction (P < 0.0001) for total and BOUT-MVPA steps·day^-1 . The total steps·day^-1 at 18 months were WL ≥ 10% = 9,822 (95% CI: 9,073-10,571), WL < 10% = 8,612 (7,613-9,610), WL < 5% = 7,802 (6,782-8,822), and GAIN = 7,801 (6,549-9,053). BOUT-MVPA steps·day^-1 at 18 months were WL ≥ 10% = 3,482 (2,982-3,981), WL < 10% = 1,949 (1,269-2,629), WL < 5% = 1,735 (1,045-2,426), and GAIN = 1,075 (210-1,941). Participants were also categorized based on achieving ≥ 10% weight loss at either 6 or 18 months, and a similar pattern was observed.

Conclusions: These findings show that 10,000 steps·day^-1 , with approximately 3,500 steps·day^-1 performed as BOUT-MVPA, are associated with enhanced weight loss in a behavioral intervention.