BMC Public Health (May 2025)
Association of daily step counts and intensity in obesity among older Chinese women: a cross-sectional study
Abstract
Abstract Objectives To examine the associations of accelerometer-measured daily step counts and intensity with overweightness/obesity among older Chinese women. Methods Data were collected from 1,085 women in the Physical Activity and Health in Older Women Study (PAHIOWS) in China. Multiple linear regression analyses were used to assess the association of total daily step counts, peak cadence and their joint association with overweightness/obesity indicators. Receiver operating characteristic curve (ROC) analysis was used to determine the optimal cut-off values of daily steps and peak cadence for distinguishing overweightness/obesity. Results Daily step counts, cadence or intensity were independently associated with lower overweightness/obesity indicators. Each 1,000 step increase in daily step counts was associated with lower body fat ratio (BFR) (β: -0.22, 95%CI: -0.40, -0.04, P = 0.02) although not associated with body mass index (BMI) (β: -0.09, 95%CI: -0.19, 0.01, P = 0.07). Each 1 steps/min increase in peak 1 cadence and peak 30 cadence was associated with a lower BFR (β: -0.09, 95%CI: -0.12, -0.06, P<0.01; β: -0.08, 95%CI: -0.11, -0.05, P<0.01). The high step and intensity group was most associated with lower overweightness/obesity indicators. ROC analysis showed that the optimal cut-off points of daily step count, peak 1 cadence and peak 30 cadence for predicting overweightness/obesity were 9,135 steps, 126.9 steps/min and 89.0 steps/min, respectively. Conclusion Higher daily step counts and intensity appear associated with a lower risk of obesity, although daily step counts is not associated with BMI. For women aged 60–70, aiming for over 9,135 steps/day is suggested. Adjusting step counts and intensity according to individual circumstances is advisable.
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