Four-Year Increase in Step Cadence Is Associated with Improved Cardiometabolic Health in People with a History of Prediabetes

Purpose 

To investigate associations between 4-year change in step cadence and markers of cardiometabolic health in people with a history of prediabetes and to explore whether these associations are modified by demographic factors.

Methods 

In this prospective cohort study, adults, with a history of prediabetes, were assessed for markers of cardiometabolic health (body mass index (BMI), waist circumference, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides, and glycated haemoglobin (HbA1c) and free-living stepping activity (activPAL3™) at baseline, 1-year, and 4-years. Brisk steps/day were defined as the number of steps accumulated at ≥100 steps/minute and slow steps/day as those accumulated at <100 steps/minute; the mean peak stepping cadence during the most active 10 minutes of the day was also derived. Generalised estimating equations examined associations between 4-year change in step cadence and change in cardiometabolic risk factors, with interactions by sex and ethnicity.

Results 

794 participants were included (age = 59.8 ± 8.9 years, 48.7% women, 27.1% ethnic minority, total steps/day = 8445 ± 3364, brisk steps/day = 4794 ± 2865, peak 10-minute step cadence = 128 ± 10 steps/minute. Beneficial associations were observed between change in brisk steps/day and change in BMI, waist circumference, HDL-C, and HbA1c. Similar associations were found between peak 10-minute step cadence and HDL-C and waist circumference. Interactions by ethnicity revealed change in brisk steps/day and change in peak 10-minute step cadence had a stronger association with HbA1c in White Europeans, whereas associations between change in 10-minute peak step cadence with measures of adiposity were stronger in South Asians.

Conclusions 

Change in the number of daily steps accumulated at a brisk pace was associated with beneficial change in adiposity, HDL-C, and HbA1c; however, potential benefits may be dependent on ethnicity for outcomes related to HbA1c and adiposity.