University of Tennessee, Knoxville TRACE: Tennessee Research and Creative Exchange Doctoral Dissertations Graduate School 8-2010 The Effect of Body Mass Index on Pedometer Accuracy in a Free- Living Environment Brian Matthew Tyo [email protected] Follow this and additional works at: https://trace.tennessee.edu/utk_graddiss Part of the Other Kinesiology Commons, and the Sports Sciences Commons Recommended Citation Tyo, Brian Matthew, "The Effect of Body Mass Index on Pedometer Accuracy in a Free-Living Environment. " PhD diss., University of Tennessee, 2010. https://trace.tennessee.edu/utk_graddiss/854 This Dissertation is brought to you for free and open access by the Graduate School at TRACE: Tennessee Research and Creative Exchange. It has been accepted for inclusion in Doctoral Dissertations by an authorized administrator of TRACE: Tennessee Research and Creative Exchange. For more information, please contact [email protected]. To the Graduate Council: I am submitting herewith a dissertation written by Brian Matthew Tyo entitled "The Effect of Body Mass Index on Pedometer Accuracy in a Free-Living Environment." I have examined the final electronic copy of this dissertation for form and content and recommend that it be accepted in partial fulfillment of the equirr ements for the degree of Doctor of Philosophy, with a major in Exercise and Sport Sciences. Dixie Thompson, Major Professor We have read this dissertation and recommend its acceptance: David Bassett Jr., Eugene Fitzhugh, Naima Moustaid-Moussa, Dawn Podulka-Coe Accepted for the Council: Carolyn R. Hodges Vice Provost and Dean of the Graduate School (Original signatures are on file with official studentecor r ds.) To the Graduate Council: I am submitting herewith a dissertation written by Brian Matthew Tyo entitled “The Effect of Body Mass Index on Pedometer Accuracy in Adults and Adolescents in a Free- Living Environment.” I have examined the final electronic copy of this dissertation for form and content and recommend that it be accepted in partial fulfillment of the requirements for the degree of Doctor of Philosophy, with a major in Exercise and Sports Sciences. Dixie L. Thompson, Major Professor We have read this dissertation and recommend its acceptance: David R. Bassett, Jr. Eugene C. Fitzhugh Naima Moustaid-Moussa Dawn Podulka Coe Accepted for the Council: Carolyn R. Hodges Vice Provost and Dean of the Graduate School (Original signatures are on file with official student records.) The Effect of Body Mass Index on Pedometer Accuracy in Adults and Adolescents in a Free-Living Environment A Dissertation Presented for the Doctor of Philosophy Degree The University of Tennessee, Knoxville Brian Matthew Tyo August 2010 Dedication This dissertation is dedicated to my son, Jacob, for providing absolute joy to my life. You give me a reason to get up each and every morning. I love you and encourage you to dream and love with all your mind, heart, and soul no matter the cost. ii Acknowledgements I must thank Dr. Dixie Thompson and Dr. David Bassett for their mentoring and guidance. It would be impossible for me to repay you for all of the help, advice, and friendship you have given to me. I can only hope to someday pass along the same to future students. Your have given me a great model in which to shape my professional career. I would also like to thank Dr. Dawn Coe, your expertise helped guide me through the last leg of the dissertation process. Thanks also to Dr. Eugene Fitzhugh for your guidance and mentoring throughout my time here in Knoxville. Your insights also helped guide me through my studies. Thank you to Dr. Naima Moustaid-Moussa for providing your beneficial insights to my studies. This dissertation would have been impossible without the help and support of the Boy Scouts, Girl Scouts, and the East Tennessee Children’s Hospital Weight Management Team. Specifically, I would like to thank Dr. Randol Waters, Hank Swindle, Lise Bender, and Sherry Harris. Your patience and work ethic helped me tremendously through this process. Special thanks to Dr. Nicole Swain and Dr. Charlotte Sutton for giving me the opportunity to interact with your patients and helping me along the way. Thank you to Dinesh John, Yuri Feito, Scott Conger, Jeremy Steeves, Jennifer Flynn and Douglas Gregory for all of your help, laughs, and patience. You helped keep iii me sane throughout the last three years. Special thanks to Pam Andrews for helping me throughout my time here. Finally, I would like to thank my family for their love and support. iv Abstract The purpose of this dissertation was to determine if the New Lifestyles NL-2000 (NL) and the Digi-Walker SW-200 (DW), waist-mounted devices, yield similar daily step counts as compared to the StepWatch 3 (SW), an ankle-mounted device, worn by adults and children in the free-living environment. For the first study, fifty-six adults (32.7 + 14.5 y) wore the devices for seven consecutive days. There were 20 normal weight, 18 overweight, and 18 obese participants. The NL and DW undercounted (pedometer error) similarly in the normal weight and overweight groups (-15.4% to -18.2%, respectively). However, the DW undercounted more than the NL in the obese group (-32.8% vs -23.9%, respectively). Stepwise regression revealed that both the NL and DW had more error (undercounted more) as a greater percentage steps were accumulated while walking slowly. The DW also had more error with greater BMI. Use of the DW in an obese population will result in twice the error as compared to a normal weight population and thus the DW should not be used to determine relationships between walking volume and adiposity For the second study, 74 children (13 ± 1.1 y) wore the same devices during one weekday. There were 33 normal weight, 21 overweight, and 20 obese participants. The error was determined for the NL and DW, and the values were similar in the normal weight and overweight groups (-10.8% to -15.4%, respectively). The DW undercounted more than the NL in the obese group (-27.3% vs -8.4%, respectively). The NL was very consistent regardless of BMI category, recording 89.1% (-10.8% error), 89.1% (-10.9% v error), and 91.6% (-8.4% error) for the normal weight, overweight, and obese participants, respectively. Stepwise regression revealed that the DW undercounted more in participants with a high weight. Using the DW in obese children of this age group will result in significantly more undercounting when compared to normal weight children. The DW should not be used to determine relationships between walking volume and adiposity in this population. The NL undercounted by ~10%, regardless of BMI category. vi Table of Contents PART I: INTRODUCTION............................................................................................. 1 Statement of the Problem............................................................................................ 7 Statement of the Purpose ............................................................................................ 8 Significance of these Studies ...................................................................................... 8 References..................................................................................................................... 10 PART II: REVIEW OF LITERATURE ...................................................................... 18 The Importance of Physical Activity ........................................................................ 19 History of Physical Activity.................................................................................. 20 Physical Activity Guidelines Advisory Committee Report.......................................... 22 Physical Activity Trends....................................................................................... 23 Protective Effects of Physical Activity................................................................. 29 Obesity .............................................................................................................. 29 BMI................................................................................................................... 29 BMI Trends....................................................................................................... 33 Waist Circumference ........................................................................................ 34 Waist Circumference Trends ............................................................................ 37 Physical Activity and Obesity........................................................................... 38 The Influence of PA on Type 2 Diabetes.......................................................... 41 The Influence of Physical Activity on Cardiovascular Disease (CVD) ........... 44 The Influence of Physical Activity on Hypertension........................................ 47 The Influence of Diet and Various Behaviors on Obesity........................................ 51 Objective Monitoring.................................................................................................... 53 Doubly Labeled Water.............................................................................................. 53 Pedometers................................................................................................................ 56 Accelerometers ......................................................................................................... 67 Heart Rate Monitoring .............................................................................................