ABSTRACT Background: The health benefit associated with a daily step-count target within pedometer programs is unclear. The aim of this study was to determine if the daily step-count attained during a four month pedometer-based workplace health program was associated with change in waist circumference (WC). Methods: 762 Australian adults enrolled in a workplace pedometer program were recruited from ten workplaces in 2008. At the end of the program (four months), 436 participants were eligible for the current analysis. Data included demographics, perceived physical activity change during the program, measured WC at baseline and follow-up, and reported daily pedometer step-counts throughout the program. The association between daily step count and change in WC was examined using linear regression. Results: WC improved by an average of –1.61cm (95% CI: –2.13, –1.09) by the end of the program. There was no relationship between daily step-count and the degree of change in WC. However, among participants reporting an increase in physical activity during the program a relationship between daily step count and change in WC was observed, such that those who undertook on average 10,000 steps or more per day improved their WC by –1.38cm (95%CI: –2.14, –0.63) more than those who did not achieve an average of 10,000 steps per day. Similarly, among individuals not meeting WC guidelines at baseline a greater daily step count was associated with a greater decrease in WC. Conclusions: Within a workplace pedometer program, reported daily step count was not associated with greater reductions in WC. However, it was a useful indicator of potential health benefits in those who increased their level of physical activity during the program. Pedometer programs need to communicate clearly the importance of both a step goal and improvement in step count to manage participant expectations about improvements in health markers.
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Backholer, K. , Freak-Poli, R. and Peeters, A. (2012) Daily step-count and change in waist circumference during a workplace pedometer program. Open Journal of Preventive Medicine, 2, 249-256. doi: 10.4236/ojpm.2012.22036.
 World Health Organization. (2008) Preventing noncommunicable diseases in the workplace through diet and physical activity: WHO/World Economic Forum report of a joint event. WHO, Geneva.
 Proper, K.I., Koning, M., van der Beek, A.J., Hildebrandt, V.H., Bosscher, R.J. and van Mechelen, W. (2003) The effectiveness of worksite physical activity programs on physical activity, physical fitness, and health. Clinical Journal of Sport Medicine, 13, 106-117.
 Tudor-Locke, C., Williams, J.E., Reis, J.P. and Pluto, D. (2002) Utility of pedometers for assessing physical activity: convergent validity. Sports Medicine, 32, 795-808.
 Dugdill, L. and Springett, J. (2001) Evaluating health promotion programmes in the workplace. WHO Regional Publications (European Series), 92, 285-308.
 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. The Journal of the American Medical Association, 298, 2296-2304.
 Richardson, C.R., Newton, T.L., Abraham, J.J., Sen, A., Jimbo, M., Swartz and A.M. (2008) A meta-analysis of pedometer-based walking interventions and weight loss. The Annals of Family Medicine, 6, 69-77.
 Cobiac, L.J., Vos, T. and Ba-rendregt, J.J. (2009) Cost-effectiveness of interventions to promote physical activity: A modelling study. PLoS Medicine, 6, e1000110.
 Tudor-Locke, C. (2010) Steps to better cardiovascular health: How many steps does it take to achieve good health and how confident are we in this number? Current Cardiovascular Risk Reports, 4, 271-276.
 Freak-Poli, R., Wolfe, R., Backholer, K., de Courten, M. and Peeters, A. (2011) Impact of a pedometer-based work-place health program on cardiovascular and diabetes risk profile. Preventive Medicine, 53, 162-171.
 Hatano, Y. (1993) Use of the pedometer for promoting daily walking exercise. Journal of the International Com- mittee on Health, Physical Education and Recreation, 29, 4-8.
 Tudor-Locke, C., Hatano, Y., Pangrazi, R.P. and Kang, M. (2008) Revisiting “how many steps are enough?” Medi- cine & Science in Sports & Exercise, 40, S537-543.
 Freak-Poli, W.R., Backholer, K., de Courten, M., Peeters, A. (2011) Change in cardiovascular and diabetes risk as- sociated with participation in a four month workplace pedome-ter-based intervention. Preventive Medicine, in Press.
 National Health and Medical Research Council. (2003) Clinical practice guidelines for the management of overweight and obesity in adults. Department of Health and Ageing of Australian Government, Canberra, 45-47.
 Tudor-Locke, C. and Bassett, D.R. Jr. (2004) How many steps/day are enough? Preliminary pedometer indices for public health. Sports Medicine, 34, 1-8.
 Chan, C.B., Ryan, D.A. and Tudor-Locke, C. (2004) Health benefits of a pedometer-based physical activity intervenetion in sedentary workers. Preventive Medicine, 39, 1215-1222. doi:10.1016/j.ypmed.2004.04.053
 Slentz, C.A., Duscha, B.D., Johnson, J.L., Ketchum, K., Aiken, L.B., Samsa, G.P., Houmard, J.A., Bales, C.W. and Kraus, W.E. (2004) Effects of the amount of exercise on body weight, body composition, and measures of central obesity. STRRIDE—A randomized controlled study. Archives of Internal Medicine, 164, 31-39.
 Ball, K., Crawford, D., Ireland, P. and Hodge, A. (2003) Patterns and demographic predictors of 5-year weight change in a multi-ethnic cohort of men and women in Australia. Public Health Nutrition, 6, 269-281. doi:10.1079/PHN2002431
 Lundgren, H., Bengtsson, C., Blohme, G., Lapidus, L. and Sjostrom, L. (1989) Adiposity and adipose tissue distribution in relation to incidence of diabetes in women: Results from a prospective population study in Gothenburg, Sweden. International Journal of Obesity, 13, 413-423.
 Friedl, K.E. (2009) Waist circumference threshold values for type 2 diabetes risk. Journal of Diabetes Science and Technology, 3, 761-769.
 Wang, Y., Rimm, E.B., Stampfer, M.J., Willett, W.C. and Hu, F.B. (2005) Comparison of abdominal adiposity and overall obesity in predicting risk of type 2 diabetes among men. The American Journal of Clinical Nutrition, 81, 555-563.
 Larsson, B., Svardsudd, K., Welin, L., Wilhelmsen, L., Bjorntorp, P. and Tibblin, G. (1984) Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13 year follow up of participants in the study of men born in 1913. British Medical Journal (Clinical Research Edition), 288, 1401-1404.
 Cameron, A.J., Dunstan, D.W., Owen, N., Zimmet, P.Z., Barr, E.L., Tonkin, A.M., Magliano, D.J., Murray, S.G., Welborn, T.A. and Shaw, J.E. (2009) Health and mortality consequences of abdominal obesity: evidence from the Aus-Diab study. Medical Journal of Australia, 191, 202- 208.
 Seidell, J.C. (2010) Waist circumference and waist/hip ratio in relation to all-cause mortality, cancer and sleep apnea. European Journal of Clinical Nutrition, 64, 35-41.