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The inverse relationship between number of steps per day and obesity in a population-based sample – the AusDiab study



Physical activity (PA) is inversely associated with obesity but the effect has been difficult to quantify using questionnaires. In particular, the shape of the association has not yet been well described. Pedometers provide an opportunity to better characterize the association.


Residents of households over the age of 25 years in randomly selected census districts in Tasmania were eligible to participate in the AusDiab cross-sectional survey conducted in 1999–2000. 1848 completed the AusDiab survey and 1126 of these (609 women and 517 men) wore a pedometer for 2-weekdays. Questionnaire data on recent PA, TV time and other factors were obtained. The outcomes were waist circumference (in cm) and body mass index (BMI) (kg/m2).


Increasing daily steps were associated with a decline in the obesity measures. The logarithmic nature of the associations was indicated by a sharper decline for those with lower daily steps. For example, an additional 2000 steps for those taking only 2000 steps per day was associated with a reduction of 2.8 (95% confidence interval (CI): 2.1,4.4) cm in waist circumference among men (for women; 2.2 (95% CI: 0.6, 3.9 cm)) with a baseline of only 2000, steps compared to a 0.7 (95% CI 0.3, 1.1) cm reduction (for women; 0.6 (95% CI: 0.2, 1.0)) for those already walking 10 000 steps daily. In the multivariable analysis, clearer associations were detected for PA and these obesity measures using daily step number rather than PA time by questionnaire.


Pedometer measures of activity indicate that the inverse association between recent PA and obesity is logarithmic in form with the greatest impact for a given arithmetic step number increase seen at lower levels of baseline activity. The findings from this study need to be examined in prospective settings.

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We are most grateful to the following for their financial support of the study: The Commonwealth Department of Health and Aged Care, Abbott Australasia Pty Ltd, Alphapharm Pty Ltd, Aventis Pharmaceutical, AstraZeneca, Bristol-Myers Squibb Pharmaccuticals, Eli Lilly (Australia) Pty Ltd, GlaxoSmithKline, Janssen-Cilag (Australia) Pty Ltd, Merck Lipha s.a., Merck Sharp & Dohme (Australia), Novartis Pharmaceutical (Australia) Pty Ltd, Novo Nordisk Pharmaceutical Pty Ltd, Pharmacia and Upjohn Pty Ltd, Pfizer Pty Ltd, Roche Diagnostics, Sanofi Synthelabo (Australia) Pty Ltd, Servier Laboratories (Australia) Pty Ltd, BioRad Laboratories Pty Ltd, HITECH Pathology Pty Ltd, the Australian Kidney Foundation, Diabetes Australia, Diabetes Australia (Northern Territory), Queensland Health, South Australian Department of Human Services, Tasmanian Department of Health and Human Services, Territory Health Services, Victorian Department of Human Services, and Health Department of Western Australia. DD is supported by a National Health and Medical Research Council (NHMRC) Post-Doctoral Research Fellowship. JS is supported by a Victorian Health Promotion Foundation Public Health Research Fellowship. A-L Ponsonby provided comments on the manuscript draft. Also, for their invaluable contribution to the field activities of AusDiab, we are enormously grateful to Annie Allman, Marita Dalton, Adam Meehan, Clare Reid, Alison Stewart, Robyn Tapp and James Dilger. The AusDiab Steering Committee consisted of Dr B Atkins, Dr S Bennett, Dr S Chadban, Professor S Colagiuri, Dr M de Courten, Dr M D'Embden, Dr D Dunstan, Professor T Dwyer, Dr D Jolley, Dr P Magnus, Professor J Mathews, Dr D McCarty, Professor K O'Dea, Dr P Phillips, Dr P Popplewell, Mr I Kemp, Professor H Taylor, Professor T Welborn and Professor P Zimmet. Role of the Funding Source: The funding source had no such involvement in study design, collection, analysis and interpretation of data, in the writing of the report and in the decision to submit the paper for publication. Contributors: Terence Dwyer, Alison Venn, Leigh Blizzard and Paul Zimmet designed and implemented the study. Jenny Cochrane contributed to study implementation. David Hosmer, Trina Hosmer and Leigh Blizzard conducted the statistical analyses. All authors contributed to the interpretation of the study findings and the writing and revision of manuscript. Terence Dwyer is the guarantor of the paper.

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Dwyer, T., Hosmer, D., Hosmer, T. et al. The inverse relationship between number of steps per day and obesity in a population-based sample – the AusDiab study. Int J Obes 31, 797–804 (2007).

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  • physical activity
  • pedometer
  • body mass index
  • waist circumference

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