Shelly K. McCrady

Activity-promoting video games and increased energy expenditure.

OBJECTIVES To test the hypothesis that both children and adults would expend more calories and move more while playing activity-promoting video games compared with sedentary video games. STUDY DESIGN In this single-group study, 22 healthy children (12 +/- 2 years; 11 male, 11 female) and 20 adults (34 +/- 11 years; 10 male, 10 female) were recruited. Energy expenditure and physical activity were measured while participants were resting, standing, watching television seated, sitting and playing a traditional sedentary video game, and while playing an activity-promoting video game (Nintendo Wii Boxing). Physical activity was measured with accelerometers, and energy expenditure was measured with an indirect calorimeter. RESULTS Energy expenditure was significantly greater than all other activities when children or adults played Nintendo Wii (mean increase over resting, 189 +/- 63 kcal/hr, P < .001, and 148 +/- 71 kcal/hr, P < .001, respectively). When examining movement with accelerometry, children moved significantly more than adults (55 +/- 5 arbitrary acceleration units and 23 +/- 2 arbitrary acceleration units, respectively, P < .001) while playing Nintendo Wii. CONCLUSION Activity-promoting video games have the potential to increase movement and energy expenditure in children and adults.

The Role of Free-Living Daily Walking in Human Weight Gain and Obesity

OBJECTIVE—Diminished daily physical activity explains, in part, why obesity and diabetes have become worldwide epidemics. In particular, chair use has replaced ambulation, so that obese individuals tend to sit for ∼2.5 h/day more than lean counterparts. Here, we address the hypotheses that free-living daily walking distance is decreased in obesity compared with lean subjects and that experimental weight gain precipitates decreased daily walking. RESEARCH DESIGN AND METHODS—During weight-maintenance feeding, we measured free-living walking using a validated system that captures locomotion and body movement for 10 days in 22 healthy lean and obese sedentary individuals. These measurements were then repeated after the lean and obese subjects were overfed by 1,000 kcal/day for 8 weeks. RESULTS—We found that free-living walking comprises many (∼47) short-duration (<15 min), low-velocity (∼1 mph) walking bouts. Lean subjects walked 3.5 miles/day more than obese subjects (n = 10, 10.3 ± 2.5 vs. n = 12, 6.7 ± 1.8 miles/day; P = 0.0009). With overfeeding, walking distance decreased by 1.5 miles/day compared with baseline values (−1.5 ± 1.7 miles/day; P = 0.0005). The decrease in walking that accompanied overfeeding occurred to a similar degree in the lean (−1.4 ± 1.9 miles/day; P = 0.04) and obese (−1.6 ± 1.7 miles/day; P = 0.008) subjects. CONCLUSIONS—Walking is decreased in obesity and declines with weight gain. This may represent a continuum whereby progressive increases in weight are associated with progressive decreases in walking distance. By identifying walking as pivotal in weight gain and obesity, we hope to add credence to an argument for an ambulatory future.

Sedentariness at work: How much do we really sit

Sedentariness is associated with obesity. We examined whether people with sedentary jobs are equally inactive during their work days and leisure days. We enrolled 21 subjects of varying weight and body fat (11 men:10 women, 38 ± 8 years, 83 ± 17 kg, BMI 28 ± 5 kg/m2, 29 ± 11 fat kg, 35 ± 9% fat). All subjects continued their usual work and leisure‐time activities whilst we measured daily activity and body postures for 10 days. The data supported our hypothesis that people sit more at work compared to leisure (597 ± 122 min/day cf 484 ± 83 min/day; P < 0.0001). The mean difference was 110 ± 99 min/day. Similarly, work days were associated with less standing (341 ± 97 min/day; P = 0.002) than leisure days (417 ± 101 min/day). Although the walking bouts did not differ significantly between work and leisure (46 ± 9 vs. 42 ± 9 walking bouts/day); the mean free‐living velocity of a walk at work was 1.08 ± 0.28 mph and on leisure days was 0.94 ± 0.24 mph (P = 0.03) and the average time spent walking was 322 ± 91 min on work days and 380 ± 108 min on leisure days (P = 0.03). Estimates of the daily energetic cost of walking approximated 527 ± 220 kcal/day for work days and 586 ± 326 kcal/day for leisure days (r = 0.72, P < 0.001). Work days are associated with more sitting and less walking/standing time than leisure days. We suggest a need to develop approaches to free people from their chairs and render them more active.

Changing the School Environment to Increase Physical Activity in Children

We examined the hypothesis that elementary school‐age children will be more physically active while attending school in a novel, activity‐permissive school environment compared to their traditional school environment. Twenty‐four children were monitored with a single‐triaxial accelerometer worn on the thigh. The students attended school in three different environments: traditional school with chairs and desks, an activity‐permissive environment, and finally their traditional school with desks which encouraged standing. Data from the school children were compared with another group of age‐matched children (n = 16) whose physical activity was monitored during summer vacation. When children attended school in their traditional environment, they moved an average (mean ± s.d.) of 71 ± 0.4 m/s2. When the children attended school in the activity‐permissive environment, they moved an average of 115 ± 3 m/s2. The children moved 71 ± 0.7 m/s2 while attending the traditional school with standing desks. Children moved significantly more while attending school in the activity‐permissive environment compared to the amount that they moved in either of the traditional school environments (P < 0.0001 for both). Comparing childrens activity while they were on summer vacation (113 ± 8 m/s2) to school‐bound children in their traditional environment showed significantly more activity for the children on summer vacation (P < 0.0001). The school children in the activity‐permissive environment were as active as children on summer vacation. Children will move more in an activity‐permissive environment. Strategies to increase the activity of school children may involve re‐designing the school itself.

Energy Expenditure and Activity of Transfemoral Amputees Using Mechanical and Microprocessor-Controlled Prosthetic Knees

OBJECTIVE To quantify the energy efficiency of locomotion and free-living physical activity energy expenditure of transfemoral amputees using a mechanical and microprocessor-controlled prosthetic knee. DESIGN Repeated-measures design to evaluate comparative functional outcomes. SETTING Exercise physiology laboratory and community free-living environment. PARTICIPANTS Subjects (N=15; 12 men, 3 women; age, 42+/-9 y; range, 26-57 y) with transfemoral amputation. INTERVENTION Research participants were long-term users of a mechanical prosthesis (20+/-10 y as an amputee; range, 3-36 y). They were fitted with a microprocessor-controlled knee prosthesis and allowed to acclimate (mean time, 18+/-8 wk) before being retested. MAIN OUTCOME MEASURES Objective measurements of energy efficiency and total daily energy expenditure were obtained. The Prosthetic Evaluation Questionnaire was used to gather subjective feedback from the participants. RESULTS Subjects demonstrated significantly increased physical activity-related energy expenditure levels in the participants free-living environment (P=.04) after wearing the microprocessor-controlled prosthetic knee joint. There was no significant difference in the energy efficiency of walking (P=.34). When using the microprocessor-controlled knee, the subjects expressed increased satisfaction in their daily lives (P=.02). CONCLUSIONS People ambulating with a microprocessor-controlled knee significantly increased their physical activity during daily life, outside the laboratory setting, and expressed an increased quality of life.

An office-place stepping device to promote workplace physical activity

Objective: It was proposed that an office-place stepping device is associated with significant and substantial increases in energy expenditure compared to sitting energy expenditure. The objective was to assess the effect of using an office-place stepping device on the energy expenditure of lean and obese office workers. Methods: The office-place stepping device is an inexpensive, near-silent, low-impact device that can be housed under a standard desk and plugged into an office PC for self-monitoring. Energy expenditure was measured in lean and obese subjects using the stepping device and during rest, sitting and walking. 19 subjects (27±9 years, 85±23 kg): 9 lean (BMI<25 kg/m2) and 10 obese (BMI>29 kg/m2) attended the experimental office facility. Energy expenditure was measured at rest, while seated in an office chair, standing, walking on a treadmill and while using the office-place stepping device. Results: The office-place stepping device was associated with an increase in energy expenditure above sitting in an office chair by 289±102 kcal/hour (p<0.001). The increase in energy expenditure was greater for obese (335±99 kcal/hour) than for lean subjects (235±80 kcal/hour; p = 0.03). The increments in energy expenditure were similar to exercise-style walking. Conclusion: The office-place stepping device could be an approach for office workers to increase their energy expenditure. If the stepping device was used to replace sitting by 2 hours per day and if other components of energy balance were constant, weight loss of 20 kg/year could occur.

Non-exercise Physical Activity in Agricultural and Urban People

With evidence that urbanisation is associated with obesity, diabetes, hypertension and cardiovascular disease, this article compares daily physical activity between rural and urban dwellers. Specifically, it examines habitual daily activity levels, non-exercise activity thermogenesis (NEAT) and energy expenditure in agricultural and urban Jamaicans and urban North Americans. Ambulation was 60 per cent greater in rural Jamaicans than in the urban dwellers (4675 ± 2261 versus 2940 ± 1120 ambulation-attributed arbitrary units (AU)/day; P = 0.001). Levels of ambulation in lean urban Jamaicans were similar to those in lean urban North Americans, whereas obese urban dwellers walked less than their lean urban counterparts (2198 ± 516 versus 2793 ± 774 AU/day; P = 0.01). The data with respect to daily sitting mirrored the walking data; obese Americans sat for almost four hours more each day than rural Jamaicans (562 ± 78 versus 336 ± 68 minutes/day; P < 0.001). Urbanisation is associated with low levels of daily activity and NEAT.

Evaluation of the Accuracy of a Triaxial Accelerometer Embedded into a Cell Phone Platform for Measuring Physical Activity

BACKGROUND Physical activity is important in health and weight management. Several cell phone platforms integrate an accelerometer onto the motherboard. Here we tested the validity of the cell phone accelerometer to assess physical activity in a controlled laboratory setting. METHODS 31 subjects wore the cell phone on their waist along with the validated Physical Activity Monitoring System (PAMS) with different body postures and during graded walking. Energy expenditure was measured using indirect calorimetry. 11 subjects also wore the iPhone at different locations such as arm, hand, pant pocket, etc. RESULTS The cell phone accelerometer was accurate and precise compared to the PAMS, with an intra-class correlation coefficient (r2> 0.98). The cell phone accelerometer showed excellent sequential increases with increased in walking velocity and energy expenditure (r2>0.9). CONCLUSION An accelerometer embedded into a cell phone was accurate and reliable in measuring and quantifying physical activity in the laboratory setting. Data from free-living users shows promise for deployment of a comprehensive integrated physical activity promoting and weight loss platform using such mobile technologies.