Steps/day translation of the moderate-to-vigorous physical activity guideline for children and adolescents

International Journal of Behavioral Nutrition and Physical Activity

Catrine Tudor-Locke³  William D Johnson²  Marc A Adams¹ 

[1] Exercise and Wellness Program, School of Nutrition and Health Promotion, Arizona State University, 500 N. Third Street, (Mail Code 3020), Phoenix, AZ, 85004, USA;Biostatistics Core, Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Road, Baton Rouge, LA, 70808, USA;Walking Behavior Laboratory, Pennington Biomedical Research Center, Louisiana State University, 6400 Perkins Road, Baton Rouge, LA, 70808, USA

关键词: NHANES;    National health and nutrition examination survey;    CDC;    Centers for disease control and prevention;    Translation;    Sensitivity and specificity;    Exercise;    Pedometer;   

Others  :  810408
DOI  :  10.1186/1479-5868-10-49

 received in 2012-07-14, accepted in 2013-03-21,  发布年份 2013

【 摘 要 】

Background

An evidence-based steps/day translation of U.S. federal guidelines for youth to engage in ≥60 minutes/day of moderate-to-vigorous physical activity (MVPA) would help health researchers, practitioners, and lay professionals charged with increasing youth’s physical activity (PA). The purpose of this study was to determine the number of free-living steps/day (both raw and adjusted to a pedometer scale) that correctly classified children (6–11 years) and adolescents (12–17 years) as meeting the 60-minute MVPA guideline using the 2005–2006 National Health and Nutrition Examination Survey (NHANES) accelerometer data, and to evaluate the 12,000 steps/day recommendation recently adopted by the President’s Challenge Physical Activity and Fitness Awards Program.

Methods

Analyses were conducted among children (n = 915) and adolescents (n = 1,302) in 2011 and 2012. Receiver Operating Characteristic (ROC) curve plots and classification statistics revealed candidate steps/day cut points that discriminated meeting/not meeting the MVPA threshold by age group, gender and different accelerometer activity cut points. The Evenson and two Freedson age-specific (3 and 4 METs) cut points were used to define minimum MVPA, and optimal steps/day were examined for raw steps and adjusted to a pedometer-scale to facilitate translation to lay populations.

Results

For boys and girls (6–11 years) with ≥ 60 minutes/day of MVPA, a range of 11,500–13,500 uncensored steps/day for children was the optimal range that balanced classification errors. For adolescent boys and girls (12–17) with ≥60 minutes/day of MVPA, 11,500–14,000 uncensored steps/day was optimal. Translation to a pedometer-scaling reduced these minimum values by 2,500 step/day to 9,000 steps/day. Area under the curve was ≥84% in all analyses.

Conclusions

No single study has definitively identified a precise and unyielding steps/day value for youth. Considering the other evidence to date, we propose a reasonable ‘rule of thumb’ value of ≥ 11,500 accelerometer-determined steps/day for both children and adolescents (and both genders), accepting that more is better. For practical applications, 9,000 steps/day appears to be a more pedometer-friendly value.

【 授权许可】

   
2013 Adams et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]U.S. Department of Health and Human Services: Physical Activity Guidelines for Americans. In In Physical Activity Guidelines for Americans . Washington DC: U.S. Department of Health and Human Services; 2008.
• [2]Physical Activity Guidelines Advisory Committee: Physical Activity Guidelines Advisory Committee Report. In In Physical Activity Guidelines Advisory Committee Report . Washington DC: U.S. Department of Health and Human Services; 2008.
• [3]Troiano RP, Berrigan D, Dodd KW, Masse LC, Tilert T, McDowell M: Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc 2008, 40:181-188.
• [4]Freedson PS, Miller K: Objective monitoring of physical activity using motion sensors and heart rate. Res Q Exerc Sport 2000, 71:S21-S29.
• [5]Tudor-Locke C, Craig C, Beets M, Belton S, Cardon G, Duncan S, Hatano Y, Lubans D, Olds T, Raustorp A, et al.: How many steps/day are enough? for children and adolescents. IJBNPA 2011, 8:78.
• [6]Colley RC, Janssen I, Tremblay MS: Daily step target to measure adherence to physical activity guidelines in children. Med Sci Sports Exerc 2012, 44:977-982.
• [7]Esliger DW, Probert A, Gorber SC, Bryan S, Laviolette M, Tremblay MS: Validity of the actical accelerometer step-count function. Med Sci Sports Exerc 2007, 39:1200-1204.
• [8]Tudor-Locke C, Johnson WD, Katzmarzyk PT: Accelerometer-determined steps per day in US children and youth. Med Sci Sports Exerc 2010, 42:2244-2250.
• [9]Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS): National Health and Nutrition Examination Survey Data. 2008 edition. Washington DC: U.S: Department of Health and Human Services, Centers for Disease Control and Prevention; 2006.
• [10]Welk GJ, Schaben JA, Morrow JR Jr: Reliability of accelerometry-based activity monitors: a generalizability study. Med Sci Sports Exerc 2004, 36:1637-1645.
• [11]Trost SG, McIver KL, Pate RR: Conducting accelerometer-based activity assessments in field-based research. Med SciSports Exerc 2005, 37:S531-S543.
• [12]Trost SG, Pate RR, Sallis JF, Freedson PS, Taylor WC, Dowda M, Sirard J: Age and gender differences in objectively measured physical activity in youth. Med Sci Sports Exerc 2002, 34:350-355.
• [13]Treuth MS, Schmitz K, Catellier DJ, McMurray RG, Murray DM, Almeida MJ, Going S, Norman JE, Pate R: Defining accelerometer thresholds for activity intensities in adolescent girls. Med Sci Sports Exerc 2004, 36:1259-1266.
• [14]Evenson KR, Catellier DJ, Gill K, Ondrak KS, McMurray RG: Calibration of two objective measures of physical activity for children. J Sports Sci 2008, 26:1557-1565.
• [15]Cain KL, Sallis JF, Conway TL, Van Dyck D, Calhoon L: Using accelerometers in youth physical activity studies: a review of methods. J Phys Act Health 2013, 10:437-450.
• [16]Trost SG, Loprinzi PD, Moore R, Pfeiffer KA: Comparison of accelerometer cut points for predicting activity intensity in youth. Med Sci Sports Exerc 2011, 43:1360-1368.
• [17]Tudor-Locke C, Ainsworth BE, Thompson RW, Matthews CE: Comparison of pedometer and accelerometer measures of free-living physical activity. Med Sci Sports Exerc 2002, 34:2045-2051.
• [18]Arvidsson D, Fitch M, Hudes ML, Tudor-Locke C, Fleming SE: Accelerometer response to physical activity intensity in normal-weight versus overweight African American children. J Phys Act Health 2011, 8:682-692.
• [19]Feito Y, Bassett DR, Thompson DL: Evaluation of activity monitors in controlled and free-living environments. Med Sci Sports Exerc 2012, 44:733-741.
• [20]Tudor-Locke C, Johnson WD, Katzmarzyk PT: Accelerometer-determined steps per day in US adults. Med Sci Sports Exerc 2009, 41:1384-1391.
• [21]Matthews CE, Chen KY, Freedson PS, Buchowski MS, Beech BM, Pate RR, Troiano RP: Amount of time spent in sedentary behaviors in the United States, 2003–2004. Am J Epidemiol 2008, 167:875-881.
• [22]Altman DG, Bland JM: Diagnostic tests 3: receiver operating characteristic plots. BMJ 1994, 309:188.
• [23]Metz CE: Basic principles of ROC analysis. Semin Nucl Med 1978, 8:283-298.
• [24]Tudor-Locke C, Hatano Y, Pangrazi RP, Kang M: Revisiting “How many steps are enough?”. Med Sci Sports Exerc 2008, 40:S537-S543.
• [25]Tudor-Locke C, Bassett DR Jr: How many steps/day are enough? Preliminary pedometer indices for public health. Sports Med 2004, 34:1-8.
• [26]Le Masurier GC, Lee SM, Tudor-Locke C: Motion sensor accuracy under controlled and free-living conditions. Med Sci Sport and Exerc 2004, 36:905-910.
• [27]Tudor-Locke C, Brashear MM, Johnson WD, Katzmarzyk PT: Accelerometer profiles of physical activity and inactivity in normal weight, overweight, and obese U.S. men and women. IJBNPA 2010, 7:60.
• [28]Sisson SB, Camhi SM, Tudor-Locke C, Johnson WD, Katzmarzyk PT: Characteristics of step-defined physical activity categories in U.S. adults. Am J Health Promot 2012, 26:152-159.
• [29]Adams MA, Caparosa S, Thompson S, Norman GJ: Translating physical activity recommendations for overweight adolescents to steps per day. Am J Prev Med 2009, 37:137-140.
• [30]Tudor-Locke C, Craig CL, Aoyagi Y, Bell RC, Croteau KA, De Bourdeaudhuij I, Ewald B, Gardner AW, Hatano Y, Lutes LD, et al.: How many steps/day are enough? For older adults and special populations. IJBNPA 2011, 8:80.
• [31]Ogden C, Carroll M: Prevalence of obesity among children and adolescents: United States, trends 1963–1965 through 2007–2008. Atlanta: Centers for Disease Control and Prevention National Center for Health Statistics; 2010.
• [32]President’s Council on Physical Fitness and Sports: The President’s Challenge Physical Activity and Fitness Awards Program. In President’s Council on Physical Fitness and Sports. Bloomington, IN: US Department of Health and Human Services; 2001.
• [33]Vincent SD, Pangrazi RP: An examination of the activity patterns of elementary school children. Pediatr Exerc Sci 2002, 14:432-441.
• [34]Fung K: Numbers rule your world : the hidden influence of probability and statistics on everything you do. New York: McGraw-Hill; 2010.
• [35]Beets MW, Morgan CF, Banda JA, Bornstein D, Byun W, Mitchell J, Munselle L, Rooney L, Beighle A, Erwin H: Convergent validity of pedometer and accelerometer estimates of moderate-to-vigorous physical activity of youth. J Phys Act Health 2011, 8(Suppl 2):S295-S305.
• [36]Dollman J, Olds TS, Esterman A, Kupke T: Pedometer step guidelines in relation to weight status among 5- to 16-year-old Australians. Pediatr Exerc Sci 2010, 22:288-300.