Fridolfsson Jonatan, Raustorp Anders, Börjesson Mats, Ekblom-Bak Elin, Ekblom Örjan, Arvidsson Daniel
Center for Lifestyle Intervention, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden/Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden.
Center for Health and Performance, Department of Food and Nutrition, and Sport Science, Faculty of Education, University of Gothenburg, Gothenburg, Sweden.
J Intern Med. 2025 May;297(5):492-504. doi: 10.1111/joim.20081. Epub 2025 Mar 31.
Physical activity guidelines recommend accumulating moderate-to-vigorous physical activity but interpreting and monitoring these recommendations remains challenging. Although step-based metrics from wearable devices offer a simpler approach, their relationship with health outcomes requires validation against established accelerometer measurements.
To evaluate how effectively step-based metrics capture health-related information from accelerometer data and determine optimal step cadence and intensity thresholds associated with cardiometabolic health in middle-aged adults.
Cross-sectional data from 4172 participants (aged 50-64 years) in the Swedish CArdioPulmonary bioImage Study (SCAPIS) were analyzed. Physical activity was measured using ActiGraph accelerometers, collecting both step metrics (daily steps and cadence) and full accelerometer data. Both cardiorespiratory fitness, estimated using a submaximal cycle ergometer test, and cardiometabolic health, assessed using a composite score of waist circumference, blood pressure, lipids, and glycated hemoglobin (HbA1c), were considered outcomes. Associations between physical activity and outcomes were examined using linear regression and partial least squares analysis.
Step counting metrics retained 88% of the health-related information from full accelerometer data. The optimal accelerometer intensity associated with cardiometabolic health was around four metabolic equivalents of tasks (METs). A step cadence of 80 steps/min, rather than the commonly used 100 steps/min, appeared more relevant for capturing moderate-intensity activity. Combining step and accelerometer data provided additional explanatory power for cardiometabolic health.
Step data capture most of the health-related information from accelerometer-measured physical activity in middle-aged adults. These findings support the use of step-based metrics for assessing and promoting physical activity while suggesting a need for recalibration of intensity thresholds in free-living conditions.
体育活动指南建议积累中等至剧烈强度的体育活动，但对这些建议的解读和监测仍然具有挑战性。尽管可穿戴设备基于步数的指标提供了一种更简单的方法，但其与健康结果的关系需要对照既定的加速度计测量结果进行验证。
评估基于步数的指标从加速度计数据中捕获与健康相关信息的有效性，并确定与中年人心血管代谢健康相关的最佳步频和强度阈值。
对瑞典心肺生物图像研究（SCAPIS）中4172名年龄在50-64岁之间的参与者的横断面数据进行了分析。使用ActiGraph加速度计测量体育活动，收集步数指标（每日步数和步频）以及完整的加速度计数据。将使用次极量自行车测力计测试估算的心肺适能和使用腰围、血压、血脂和糖化血红蛋白（HbA1c）综合评分评估的心血管代谢健康均视为研究结果。使用线性回归和偏最小二乘法分析体育活动与研究结果之间的关联。
步数计数指标保留了完整加速度计数据中88%的与健康相关信息。与心血管代谢健康相关的最佳加速度计强度约为4个代谢当量任务（METs）。每分钟80步的步频，而非常用的每分钟100步，似乎在捕获中等强度活动方面更具相关性。结合步数和加速度计数据为心血管代谢健康提供了额外的解释力。
步数数据捕获了中年成年人加速度计测量的体育活动中大部分与健康相关的信息。这些发现支持使用基于步数的指标来评估和促进体育活动，同时表明在自由生活条件下需要重新校准强度阈值。
