Skip to main content

Advertisement

SpringerLink
Log in

Steps Per Day

The Road to Senior Health?

  • Leading Article
  • Published:
Sports Medicine Aims and scope Submit manuscript

Abstract

In older adults, as in younger individuals, habitual moderate-intensity physical activity is associated with a reduced risk of various chronic health conditions, including certain types of cardiovascular and musculoskeletal disease and certain forms of cancer. However, the pattern of physical activity associated with such benefits remains unclear. One problem is that most investigators have examined patterns of physical activity using either subjective questionnaires or accelerometer or pedometer measurements limited to a single week, despite clear evidence of both the unreliability/invalidity of questionnaires and seasonal changes in activity patterns.

Since 2000, we have thus conducted an interdisciplinary study examining the habitual physical activity and health of elderly people living in a medium-sized Japanese town (the Nakanojo Study). In about one-tenth of some 5000 available subjects aged ≥65 years, physical activity has already been assessed continuously for 24 h/day for >8 years using a specially adapted pedometer/accelerometer. This device has a storage capacity of 36 days and can distinguish >10 intensities of physical activity (expressed in metaboliwc equivalents [METs]). Data have to date been summarized as daily step counts and daily durations of activity of <3 and >3 METs, averaged over a 1-year period. This article provides a detailed overview of both factors influencing habitual physical activity and relationships between such activity and health in an elderly population.

To date, analyses have been cross-sectional in type. Substantial associations have been noted between the overall health of participants and both the daily duration of effort undertaken at an intensity of >3 METs and the daily step count. In men, the extent of health is associated more closely with the daily duration of activity of >3 METs than with the daily step count, whereas in women, the association is closer for the step count than for the duration of activity >3 METs. In both sexes, the threshold amount of physical activity associated with better health is greater for physical than for mental benefits: >8000 versus >4000 steps/day and/or >20 versus >5 min/day at an intensity >3 METs, respectively. In other words, better physical health is seen in those spending at least 20 min/day in moderate walking (at a pace of around 1.4 m/s [5 km/h]) and a further >60 min of light activity per day. In contrast, better mental health is associated with much smaller amounts of deliberate physical activity.

The daily step count and the daily durations of activity of <3 and >3 METs are all influenced by meteorological factors, particularly precipitation and mean ambient temperature. Activity decreases exponentially to about 4000 steps/day as precipitation increases. Excluding the influence of rainfall, the daily step count peaks at a mean outdoor temperature of around 17°C; above and especially below such readings, physical activity decreases as a quadratic function of temperature. Seasonal changes in microclimate should thus be considered when designing interventions intended to increase the habitual physical activity of elderly people.

The observed associations between physical activity and health outcomes point to a need for longitudinal analyses; these should examine potential causal interpretations of the current findings and elucidate possible additional mediating variables.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Table I
Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. American College of Sports Medicine Position Stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc 1998 Jun; 30 (6): 975–91

    Article  Google Scholar 

  2. American College of Sports Medicine Position Stand. Exercise and physical activity for older adults. Med Sci Sports Exerc 1998 Jun; 30 (6): 992–1008

    Article  Google Scholar 

  3. Aoyagi Y, Shephard RJ. Aging and muscle function. Sports Med 1992 Dec; 14 (6): 376–96

    Article  PubMed  CAS  Google Scholar 

  4. Nelson ME, Rejeski WJ, Blair SN, et al. Physical activity and public health in older adults: recommendation from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 2007 Aug; 39 (8): 1435–45

    Article  PubMed  Google Scholar 

  5. Shephard RJ. Aging, physical activity, and health. Champaign (IL): Human Kinetics, 1997

    Google Scholar 

  6. Blair SN, Haskell WL. Objectively measured physical activity and mortality in older adults. JAMA 2006 Jul 12; 296 (2): 216–8

    Article  PubMed  CAS  Google Scholar 

  7. Brahm H, Mallmin H, Michaelsson K, et al. Relationships between bone mass measurements and lifetime physical activity in a Swedish population. Calcif Tissue Int 1998 May; 62 (5): 400–12

    Article  PubMed  CAS  Google Scholar 

  8. Coupland CA, Grainge MJ, Cliffe SJ, et al. Occupational activity and bone mineral density in postmenopausal women in England. Osteoporos Int 2000 May; 11 (4): 310–5

    Article  PubMed  CAS  Google Scholar 

  9. Evans EM, Ross KM, Heinrichs KL, et al. Ultrasound of the calcaneus and bone mineral density differs in older black and white women but is not impacted by current physical activity. Osteoporos Int 2005 Dec; 16 (12): 1755–60

    Article  PubMed  Google Scholar 

  10. Greendale GA, Barrett-Connor E, Edelstein S, et al. Lifetime leisure exercise and osteoporosis: the Rancho Bernardo study. Am J Epidemiol 1995 May 15; 141 (10): 951–9

    PubMed  CAS  Google Scholar 

  11. Kakiyama T, Matsuda M, Koseki S. Effect of physical activity on the distensibility of the aortic wall in healthy males. Angiology 1998 Sep; 49 (9): 749–57

    Article  PubMed  CAS  Google Scholar 

  12. Laaksonen DE, Lakka HM, Salonen JT, et al. Low levels of leisure-time physical activity and cardiorespiratory fitness predict development of the metabolic syndrome. Diabetes Care 2002 Sep; 25 (9): 1612–8

    Article  PubMed  Google Scholar 

  13. Lee C, Russell A. Effects of physical activity on emotional well-being among older Australian women: cross-sectional and longitudinal analyses. J Psychosom Res 2003 Feb; 54 (2): 155–60

    Article  PubMed  Google Scholar 

  14. Medras M, Slowinska-Lisowska M, Jozkow P. Impact of recreational physical activity on bone mineral density in middle-aged men. Aging Male 2005 Sep–Dec; 8 (3–4): 162–5

    Article  PubMed  CAS  Google Scholar 

  15. Nguyen TV, Center JR, Eisman JA. Osteoporosis in elderly men and women: effects of dietary calcium, physical activity, and body mass index. J Bone Miner Res 2000 Feb; 15 (2): 322–31

    Article  PubMed  CAS  Google Scholar 

  16. Pescatello LS, Murphy DM, Anderson D, et al. Daily physical movement and bone mineral density among a mixed racial cohort of women. Med Sci Sports Exerc 2002 Dec; 34 (12): 1966–70

    Article  PubMed  CAS  Google Scholar 

  17. Washburn RA, McAuley E, Katula J, et al. The physical activity scale for the elderly (PASE): evidence for validity. J Clin Epidemiol 1999 Jul; 52 (7): 643–51

    Article  PubMed  CAS  Google Scholar 

  18. Stewart AL, Mills KM, King AC, et al. CHAMPS physical activity questionnaire for older adults: outcomes for interventions. Med Sci Sports Exerc 2001 Jul; 33 (7): 1126–41

    PubMed  CAS  Google Scholar 

  19. Bennett GG, Wolin KY, Puleo E, et al. Pedometer-determined physical activity among multiethnic low-income housing residents. Med Sci Sports Exerc 2006 Apr; 38 (4): 768–73

    Article  PubMed  Google Scholar 

  20. Cavanaugh JT, Coleman KL, Gaines JM, et al. Using step activity monitoring to characterize ambulatory activity in community-dwelling older adults. J Am Geriatr Soc 2007 Jan; 55 (1): 120–4

    Article  PubMed  Google Scholar 

  21. Chan CB, Spangler E, Valcour J, et al. Cross-sectional relationship of pedometer-determined ambulatory activity to indicators of health. Obes Res 2003 Dec; 11 (12): 1563–70

    Article  PubMed  Google Scholar 

  22. Clemes SA, Matchett N, Wane SL. Reactivity: an issue for short-term pedometer studies? Br J Sports Med 2008 Jan; 42 (1): 68–70

    Article  PubMed  CAS  Google Scholar 

  23. Dwyer T, Hosmer D, Hosmer T, et al. The inverse relationship between number of steps per day and obesity in a population-based sample: the AusDiab study. Int J Obes 2007 May; 31 (5): 797–804

    CAS  Google Scholar 

  24. Gerdhem P, Dencker M, Ringsberg K, et al. Accelerometer-measured daily physical activity among octogenerians: results and associations to other indices of physical performance and bone density. Eur J Appl Physiol 2008 Jan; 102 (2): 173–80

    Article  PubMed  Google Scholar 

  25. Kitagawa J, Omasu F, Nakahara Y. Effect of daily walking steps on ultrasound parameters of the calcaneus in elderly Japanese women. Osteoporos Int 2003 May; 14 (3): 219–24

    PubMed  CAS  Google Scholar 

  26. Shimizu K, Kimura F, Akimoto T, et al. Effect of free-living daily physical activity on salivary secretory IgA in elderly. Med Sci Sports Exerc 2007 Apr; 39 (4): 593–8

    Article  PubMed  Google Scholar 

  27. Strycker LA, Duncan SC, Chaumeton NR, et al. Reliability of pedometer data in samples of youth and older women. Int J Behav Nutr Phys Act 2007 Feb 17; 4: 4

    Article  PubMed  Google Scholar 

  28. Sugawara J, Otsuki T, Tanabe T, et al. Physical activity duration, intensity, and arterial stiffening in postmenopausal women. Am J Hypertens 2006 Oct; 19 (10): 1032–6

    Article  PubMed  Google Scholar 

  29. Troiano RP, Berrigan D, Dodd KW, et al. Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc 2008 Jan; 40 (1): 181–8

    PubMed  Google Scholar 

  30. Trost SG, McIver KL, Pate RR. Conducting accelerometer-based activity assessments in field-based research. Med Sci Sports Exerc 2005 Nov; 37 (11 Suppl.): 531S–43S

    Google Scholar 

  31. Tudor-Locke C, Burkett L, Reis JP, et al. How many days of pedometer monitoring predict weekly physical activity in adults? Prev Med 2005 Mar; 40 (3): 293–8

    Article  PubMed  CAS  Google Scholar 

  32. Tudor-Locke C, Bassett Jr DR, Rutherford WJ, et al. BMI-referenced cut points for pedometer-determined steps per day in adults. J Phys Act Health 2008 Jan; 5 (1 Suppl.): 126S–39S

    Google Scholar 

  33. Walsh JT, Charlesworth A, Andrews R, et al. Relation of daily activity levels in patients with chronic heart failure to long-term prognosis. Am J Cardiol 1997 May 15; 79 (10): 1364–9

    Article  PubMed  CAS  Google Scholar 

  34. Ward DS, Evenson KR, Vaughn A, et al. Accelerometer use in physical activity: best practices and research recommendations. Med Sci Sports Exerc 2005 Nov; 37 (11 Suppl.): 582S–8S

    Google Scholar 

  35. Westerterp KR. Pattern and intensity of physical activity. Nature 2001 Mar 29; 410 (6828): 539

    Article  PubMed  CAS  Google Scholar 

  36. Wyatt HR, Peters JC, Reed GW, et al. A Colorado statewide survey of walking and its relation to excessive weight. Med Sci Sports Exerc 2005 May; 37 (5): 724–30

    Article  PubMed  Google Scholar 

  37. Yoshioka M, Ayabe M, Yahiro T, et al. Long-period accelerometer monitoring shows the role of physical activity in overweight and obesity. Int J Obes 2005 May; 29 (5): 502–8

    CAS  Google Scholar 

  38. Togo F, Watanabe E, Park H, et al. Meteorology and the physical activity of the elderly: the Nakanojo Study. Int J Biometeorol 2005 Nov; 50 (2): 83–9

    Article  PubMed  Google Scholar 

  39. Togo F, Watanabe E, Park H, et al. How many days of pedometer use predict the annual activity of the elderly reliably? Med Sci Sports Exerc 2008 Jun; 40 (6): 1058–64

    Article  PubMed  Google Scholar 

  40. Yasunaga A, Togo F, Watanabe E, et al. Sex, age, season, and habitual physical activity of older Japanese: the Nakanojo Study. J Aging Phys Act 2008 Jan; 16 (1): 3–13

    PubMed  Google Scholar 

  41. Aoyagi Y, Togo F, Matsuki S, et al. Walking velocity measured over 5 m as a basis of exercise prescription for the elderly: preliminary data from the Nakanojo Study. Eur J Appl Physiol 2004 Oct; 93 (1–2): 217–23

    Article  PubMed  Google Scholar 

  42. Park H, Togo F, Watanabe E, et al. Relationship of bone health to yearlong physical activity in older Japanese adults: cross-sectional data from the Nakanojo Study. Osteoporos Int 2007 Mar; 18 (3): 285–93

    Article  PubMed  CAS  Google Scholar 

  43. Park S, Park H, Togo F, et al. Yearlong physical activity and metabolic syndrome in older Japanese adults: cross-sectional data from the Nakanojo Study. J Gerontol A Biol Sci Med Sci 2008 Oct; 63 (10): 1119–23

    Article  PubMed  Google Scholar 

  44. Yasunaga A, Togo F, Watanabe E, et al. Yearlong physical activity and health-related quality of life in older Japanese adults: the Nakanojo Study. J Aging Phys Act 2006 Jul; 14 (3): 288–301

    PubMed  Google Scholar 

  45. Yasunaga A, Park H, Watanabe E, et al. Development and evaluation of the physical activity questionnaire for elderly Japanese: the Nakanojo Study. J Aging Phys Act 2007 Oct; 15 (4): 398–411

    PubMed  Google Scholar 

  46. Yoshiuchi K, Nakahara R, Kumano H, et al. Yearlong physical activity and depressive symptoms in older Japanese adults: cross-sectional data from the Nakanojo Study. Am J Geriatr Psychiatry 2006 Jul; 14 (7): 621–4

    Article  PubMed  Google Scholar 

  47. Janz KF. Physical activity in epidemiology: moving from questionnaire to objective measurement. Br J Sports Med 2006 Mar; 40 (3): 191–2

    Article  PubMed  CAS  Google Scholar 

  48. Crouter SE, Schneider PL, Karabulut M, et al. Validity of 10 electronic pedometers for measuring steps, distance, and energy cost. Med Sci Sports Exerc 2003 Aug; 35 (8): 1455–60

    Article  PubMed  Google Scholar 

  49. Kumahara H, Schutz Y, Ayabe M, et al. The use of uniaxial accelerometry for the assessment of physical-activity-related energy expenditure: a validation study against whole-body indirect calorimetry. Br J Nutr 2004 Feb; 91 (2): 235–43

    Article  PubMed  CAS  Google Scholar 

  50. Kumahara H, Ishii K, Tanaka H. Physical activity monitoring for health management: practical techniques and methodological issues. Int J Sport Health Sci 2006; 4: 380–93

    Article  Google Scholar 

  51. Rafamantanantsoa HH, Ebine N, Yoshioka M, et al. Validation of three alternative methods to measure total energy expenditure against the doubly labeled water method for older Japanese men. J Nutr Sci Vitaminol 2002 Dec; 48 (6): 517–23

    Article  PubMed  Google Scholar 

  52. Schneider PL, Crouter SE, Lukajic O, et al. Accuracy and reliability of 10 pedometers for measuring steps over a 400-m walk. Med Sci Sports Exerc 2003 Oct; 35 (10): 1779–84

    Article  PubMed  Google Scholar 

  53. Schneider PL, Crouter SE, Bassett DR. Pedometer measures of free-living physical activity: comparison of 13 models. Med Sci Sports Exerc 2004 Feb; 36 (2): 331–5

    Article  PubMed  Google Scholar 

  54. Warms C. Physical activity measurement in persons with chronic and disabling conditions: methods, strategies, and issues. Fam Community Health 2006 Jan–Mar; 29 (1 Suppl.): 78S–88S

    Article  PubMed  Google Scholar 

  55. Le Masurier GC, Tudor-Locke C. Comparison of pedometer and accelerometer accuracy under controlled conditions. Med Sci Sports Exerc 2003 May; 35 (5): 867–71

    Article  PubMed  Google Scholar 

  56. Le Masurier GC, Lee SM, Tudor-Locke C. Motion sensor accuracy under controlled and free-living conditions. Med Sci Sports Exerc 2004 May; 36 (5): 905–10

    PubMed  Google Scholar 

  57. McClain JJ, Sisson SB, Washington TL, et al. Comparison of Kenz Lifecorder EX and ActiGraph accelerometers in 10-year-old children. Med Sci Sports Exerc 2007 Apr; 39 (4): 630–8

    Article  PubMed  Google Scholar 

  58. Tudor-Locke C, Ainsworth BE, Thompson RW, et al. Comparison of pedometer and accelerometer measures of free-living physical activity. Med Sci Sports Exerc 2002 Dec; 34 (12): 2045–51

    Article  PubMed  Google Scholar 

  59. Bouchard C, Shephard RJ. The model and key concepts. In: Bouchard C, Shephard RJ, Stephens T, editors. Physical activity, fitness and health. Champaign (IL): Human Kinetics, 1994: 77–97

    Google Scholar 

  60. Tudor-Locke C, Sisson SB, Collova T, et al. Pedometerdetermined step count guidelines for classifying walking intensity in a young ostensibly healthy population. Can J Appl Physiol 2005 Dec; 30 (6): 666–76

    Article  PubMed  Google Scholar 

  61. Tudor-Locke C, Bassett Jr DR. How many steps/day are enough? Preliminary pedometer indices for public health. Sports Med 2004 Jan; 34 (1): 1–8

    Article  PubMed  Google Scholar 

  62. Hill JO, Wyatt HR, Reed GW, et al. Obesity and the environment: where do we go from here? Science 2003 Feb 7; 299 (5608): 853–5

    Article  PubMed  CAS  Google Scholar 

  63. Bravata DM, Smith-Spangler C, Sundaram V, et al. Using pedometers to increase physical activity and improve health: a systematic review. JAMA 2007 Nov 21; 298 (19): 2296–304

    Article  PubMed  CAS  Google Scholar 

  64. Caspersen CJ, Pereira MA, Curran KM. Changes in physical activity patterns in the United States, by sex and cross-sectional age. Med Sci Sports Exerc 2000 Sep; 32 (9): 1601–9

    PubMed  CAS  Google Scholar 

  65. Martinez-Gonzalez MA, Varo JJ, Santos JL, et al. Prevalence of physical activity during leisure time in the European Union. Med Sci Sports Exerc 2001 Jul; 33 (7): 1142–6

    PubMed  CAS  Google Scholar 

  66. Weiss DR, O’Loughlin JL, Platt RW, et al. Five-year predictors of physical activity decline among adults in low-income communities: a prospective study. Int J Behav Nutr Phys Act 2007 Jan 18; 4: 2

    Article  PubMed  Google Scholar 

  67. Japan Ministry of Health, Labour and Welfare. The national nutrition survey in Japan 2001 [in Japanese]. Tokyo: Daiichishuppan, 2003

    Google Scholar 

  68. Fukuhara S, Suzukamo Y. Manual of SF-36v2 Japanese version [in Japanese]. Kyoto: Institute for Health Outcomes & Process Evaluation Research, 2004

    Google Scholar 

  69. Ware JE, Sherbourne CD. The MOS 36-item Short-Form Health Survey (SF-36): I, conceptual framework and item selection. Med Care 1992 Jun; 30 (6): 473–83

    Article  PubMed  Google Scholar 

  70. National Institutes of Health Osteoporosis and Related Bone Diseases, National Research Center. Bone health and osteoporosis: a guide for Asian women aged 50 and older. Bethesda (MD): National Institutes of Health, 2005

    Google Scholar 

  71. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001 May 16; 285 (19): 2486–97

    Article  Google Scholar 

  72. World Health Organization Western Pacific Region, International Association for the Study of Obesity, International Obesity Task Force. The Asia-Pacific perspective: redefining obesity and its treatment. Sydney (NSW): Health Communications Australia Pty Limited, 2000

    Google Scholar 

  73. Shephard RJ. Whistler 2001: a Health Canada/CDC conference on “Communicating physical activity and health messages: science into practice”. Am J Prev Med 2002 Oct; 23 (3): 221–5

    Article  PubMed  Google Scholar 

  74. Erlichman J, Kerbey AL, James WP. Physical activity and its impact on health outcomes: paper 2, prevention of unhealthy weight gain and obesity by physical activity — an analysis of the evidence. Obes Rev 2002 Nov; 3 (4): 273–87

    Article  PubMed  CAS  Google Scholar 

  75. Blaum CS, West NA, Haan MN. Is the metabolic syndrome, with or without diabetes, associated with progressive disability in older Mexican Americans? J Gerontol A Biol Sci Med Sci 2007 Jul; 62 (7): 766–73

    Article  PubMed  Google Scholar 

  76. Iwane M, Arita M, Tomimoto S, et al. Walking 10000 steps/day or more reduces blood pressure and sympathetic nerve activity in mild essential hypertension. Hypertens Res 2000 Nov; 23 (6): 573–80

    Article  PubMed  CAS  Google Scholar 

  77. Moreau KL, Degarmo R, Langley J, et al. Increasing daily walking lowers blood pressure in postmenopausal women. Med Sci Sports Exerc 2001 Nov; 33 (11): 1825–31

    Article  PubMed  CAS  Google Scholar 

  78. Tudor-Locke CE, Myers AM, Bell RC, et al. Preliminary outcome evaluation of the First Step Program: a daily physical activity intervention for individuals with type 2 diabetes. Patient Educ Couns 2002 May; 47 (1): 23–8

    Article  PubMed  Google Scholar 

  79. Yamanouchi K, Shinozaki T, Chikada K, et al. Daily walking combined with diet therapy is a useful means for obese NIDDM patients not only to reduce body weight but also to improve insulin sensitivity. Diabetes Care 1995 Jun; 18 (6): 775–8

    Article  PubMed  CAS  Google Scholar 

  80. McArdle W, Katch F, Katch V. Exercise physiology: energy, nutrition, and human performance. 3rd rev. ed. Philadelphia (PA): Lea & Febiger, 1991

    Google Scholar 

  81. Aoyagi Y, Katsuta S. Relationship between the starting age of training and physical fitness in old age. Can J Sport Sci 1990 Mar; 15 (1): 65–71

    PubMed  CAS  Google Scholar 

  82. Aoyagi Y, Katsuta S. The starting age of training and its effect on reduction in physical performance capability with aging. In: Kaneko M, editor. Fitness for the aged, disabled, and industrial worker. International series on sports sciences, 20. Champaign (IL): Human Kinetics, 1990: 118–24

    Google Scholar 

  83. Chan CB, Ryan DA, Tudor-Locke C. Relationship between objective measures of physical activity and weather: a longitudinal study. Int J Behav Nutr Phys Act 2006 Aug 7; 3: 21

    Article  PubMed  Google Scholar 

  84. Tudor-Locke C, Bassett DR, Swartz AM, et al. A preliminary study of one year of pedometer self-monitoring. Ann Behav Med 2004 Dec; 28 (3): 158–62

    Article  PubMed  Google Scholar 

  85. Bergstralh EJ, Sinaki M, Offord KP, et al. Effect of season on physical activity score, back extensor muscle strength, and lumbar bone mineral density. J Bone Miner Res 1990 Apr; 5 (4): 371–7

    Article  PubMed  CAS  Google Scholar 

  86. Centers for Disease Control and Prevention. Monthly estimates of leisure-time physical inactivity — United States, 1994. MMWR Morb Mortal Wkly Rep 1997 May 9; 46 (18): 393–7

    Google Scholar 

  87. Haggarty P, McNeill G, Manneh MK, et al. The influence of exercise on the energy requirements of adult males in the UK. Br J Nutr 1994 Dec; 72 (6): 799–813

    Article  PubMed  CAS  Google Scholar 

  88. Matthews CE, Freedson PS, Hebert JR, et al. Seasonal variation in household, occupational, and leisure time physical activity: longitudinal analyses from the seasonal variation of blood cholesterol study. Am J Epidemiol 2001 Jan 15; 153 (2): 172–83

    Article  PubMed  CAS  Google Scholar 

  89. Pivarnik JM, Reeves MJ, Rafferty AP. Seasonal variation in adult leisure-time physical activity. Med Sci Sports Exerc 2003 Jun; 35 (6): 1004–8

    Article  PubMed  Google Scholar 

  90. Uitenbroek DG. Seasonal variation in leisure time physical activity. Med Sci Sports Exerc 1993 Jun; 25 (6): 755–60

    PubMed  CAS  Google Scholar 

  91. US Department of Health and Human Services. Patterns and trends in physical activity. In: Physical activity and health: a report of the Surgeon General. Atlanta (GA): US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, 1996: 173–208

    Google Scholar 

  92. Lurie SJ, Gawinski B, Pierce D, et al. Seasonal affective disorder. Am Fam Physician 2006 Nov 1; 74 (9): 1521–4

    PubMed  Google Scholar 

  93. Trost SG, Owen N, Bauman AE, et al. Correlates of adults’ participation in physical activity: review and update. Med Sci Sports Exerc 2002 Dec; 34 (12): 1996–2001

    Article  PubMed  Google Scholar 

  94. Czeisler CA, Dumont M, Duffy JF, et al. Association of sleep-wake habits in older people with changes in output of circadian pacemaker. Lancet 1992 Oct 17; 340 (8825): 933–6

    Article  PubMed  CAS  Google Scholar 

  95. Duffy JF, Dijk DJ, Klerman EB, et al. Later endogenous circadian temperature nadir relative to an earlier wake time in older people. Am J Physiol 1998 Nov; 275 (5 Pt 2): R1478–87

    PubMed  CAS  Google Scholar 

  96. Togo F, Aizawa S, Arai J, et al. Influence on human sleep patterns of lowering and delaying the minimum core body temperature by slow changes in the thermal environment. Sleep 2007 Jun 1; 30 (6): 797–802

    PubMed  Google Scholar 

  97. Aoyagi Y. Endurance training, heat acclimation, and protective clothing: the thermophysiology of exercising in a hot climate [dissertation]. Toronto (ON): University of Toronto, 1996

    Google Scholar 

  98. Aoyagi Y, McLellan TM, Shephard RJ. Interactions of physical training and heat acclimation: the thermophysiology of exercising in a hot climate. Sports Med 1997 Mar; 23 (3): 173–210

    Article  PubMed  CAS  Google Scholar 

  99. Aoyagi Y, McLellan TM, Shephard RJ. Effects of training and acclimation on heat tolerance in exercising men wearing protective clothing. Eur J Appl Physiol Occup Physiol 1994 Mar; 68 (3): 234–45

    Article  PubMed  CAS  Google Scholar 

  100. Aoyagi Y, McLellan TM, Shephard RJ. Effects of 6 versus 12 days of heat acclimation on heat tolerance in lightly exercising men wearing protective clothing. Eur J Appl Physiol Occup Physiol 1995 Mar; 71 (2–3): 187–96

    Article  PubMed  CAS  Google Scholar 

  101. Aoyagi Y, McLellan TM, Shephard RJ. Determination of body heat storage in clothing: calorimetry versus thermometry. Eur J Appl Physiol Occup Physiol 1995 Mar; 71 (2–3): 197–206

    Article  PubMed  CAS  Google Scholar 

  102. Aoyagi Y, McLellan TM, Shephard RJ. Determination of body heat storage: how to select the weighting of rectal and skin temperatures for clothed subjects. Int Arch Occup Environ Health 1996 Jun; 68 (5): 325–36

    Article  PubMed  CAS  Google Scholar 

  103. Aoyagi Y, McLellan TM, Shephard RJ. Residual analysis in the determination of factors affecting the estimates of body heat storage in clothed subjects. Eur J Appl Physiol Occup Physiol 1996 May; 73 (3–4): 287–98

    Article  PubMed  CAS  Google Scholar 

  104. Aoyagi Y, McLellan TM, Shephard RJ. Effects of endurance training and heat acclimation on psychological strain in exercising men wearing protective clothing. Ergonomics 1998 Mar; 41 (3): 328–57

    Article  PubMed  CAS  Google Scholar 

  105. McLellan TM, Aoyagi Y. Heat strain in protective clothing following hot-wet or hot-dry heat acclimation. Can J Appl Physiol 1996 Apr; 21 (2): 90–108

    Article  PubMed  CAS  Google Scholar 

  106. Gordon CJ. Relationship between preferred ambient temperature and autonomic thermoregulatory function in rat. Am J Physiol 1987 Jun; 252 (6 Pt 2): R1130–7

    PubMed  CAS  Google Scholar 

  107. Bruce DG, Devine A, Prince RL. Recreational physical activity levels in healthy older women: the importance of fear of falling. J Am Geriatr Soc 2002 Jan; 50 (1): 84–9

    Article  PubMed  Google Scholar 

  108. Pell JP, Cobbe SM. Seasonal variations in coronary heart disease. QJM 1999 Dec; 92 (12): 689–96

    Article  PubMed  CAS  Google Scholar 

  109. Qiu D, Tanihata T, Aoyama H, et al. Relationship between a high mortality rate and extreme heat during the summer of 1999 in Hokkaido Prefecture, Japan. J Epidemiol 2002 May; 12 (3): 254–7

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This article focuses particularly on data from an interdisciplinary study on the habitual physical activity and health of elderly people living in Nakanojo, Gunma, Japan (the Nakanojo Study). The Nakanojo Study was supported in part by grants (Grant-in-Aid for Encouragement of Young Scientists: 12770037 and Grant-in-Aid for Scientific Research [C]: 15500503, [C]: 17500493, and [B]: 19300235) from the Japan Society for the Promotion of Science. The authors gratefully acknowledge the expert technical assistance of the research and nursing staffs of the Tokyo Metropolitan Institute of Gerontology (particularly Mr Hyuntae Park, Mr Sungjin Park, Dr Fumiharu Togo, Dr Akitomo Yasunaga and Mr Eiji Watanabe), The University of Tokyo (especially Dr Kazuhiro Yoshiuchi), and the Nakanojo Public Health Center. We would also like to thank the subjects whose participation made the Nakanojo Study possible.

No sources of funding were used to assist in the preparation of this manuscript. The authors have no conflicts of interest that are directly relevant to the content of this manuscript.

Author information

Authors and Affiliations

  1. Exercise Sciences Research Group, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakaecho, Itabashi-ku, Tokyo, 173-0015, Japan

    Yukitoshi Aoyagi

  2. Faculty of Physical Education and Health, University of Toronto, Toronto, Ontario, Canada

    Roy J. Shephard

Authors
  1. Yukitoshi Aoyagi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Roy J. Shephard
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yukitoshi Aoyagi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Aoyagi, Y., Shephard, R.J. Steps Per Day. Sports Med 39, 423–438 (2009). https://doi.org/10.2165/00007256-200939060-00001

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00007256-200939060-00001

Keywords

Search

Navigation