Pattern of Daily Steps is Associated with Weight Loss: Secondary Analysis from the Step‐Up Randomized Trial

Objective The aim of this study was to examine the association between the amount, intensity, and pattern of steps·day −1 with weight loss. Methods Participants ( N  = 260; age = 42.8 ± 8.9 y; BMI = 32.8 ± 3.5 kg/m 2 ) completed an 18‐month weight‐loss intervention that included a calorie‐restricted diet and prescribed physical activity. Participants were categorized by 18‐month weight loss as weight gain (GAIN), weight loss of 0% to < 5% (WL < 5%), 5% to < 10% (WL < 10%), or ≥ 10% (WL ≥ 10%). Steps·day −1 were measured at 0, 6, 12, and 18 months and defined as total steps·day −1 , total steps·day −1 of moderate‐to‐vigorous physical activity (MVPA) (≥3 metabolic equivalents) in bouts of ≥ 10 minutes (BOUT‐MVPA), MVPA in bouts of < 10 minutes (NON‐BOUT‐MVPA), or non‐MVPA steps·day −1 (NON‐MVPA). Results There was a weight‐loss category by time interaction ( P  < 0.0001) for total and BOUT‐MVPA steps·day −1 . The total steps·day −1 at 18 months were WL ≥ 10% = 9,822 (95% CI: 9,073‐10,571), WL < 10% = 8,612 (7,613‐9,610), WL < 5% = 7,802 (6,782‐8,822), and GAIN = 7,801 (6,549‐9,053). BOUT‐MVPA steps·day −1 at 18 months were WL ≥ 10% = 3,482 (2,982‐3,981), WL < 10% = 1,949 (1,269‐2,629), WL < 5% = 1,735 (1,045‐2,426), and GAIN = 1,075 (210‐1,941). Participants were also categorized based on achieving ≥ 10% weight loss at either 6 or 18 months, and a similar pattern was observed. Conclusions These findings show that 10,000 steps·day −1 , with approximately 3,500 steps·day −1 performed as BOUT‐MVPA, are associated with enhanced weight loss in a behavioral intervention.