Pedometers and the heart

I was pleased to see the cover of the December issue dedicated to Ralph Paffenbarger, a long-time advocate of the role of physical activity in lowering the risk of heart disease [“Exercise and the heart: A review of the early studies of Dr R.S. Paffenbarger,” BCMJ 2007;49:540-546]. While much of the recent emphasis in the media has focused on the rising rates of obesity (childhood and adult), relatively little focus has been given to the importance of physical activity for health and reduced mortality. 

The review of the early studies documenting the importance of physical activity has given credence to the evidence behind the recommendation to become more physically active. However, we all know that increasing one’s physical activity level is easier said than done. Nevertheless, it is easier to do some activity than to not eat. 

A recent study in JAMA reported that obese adults who are in good cardiovascular shape have a lower risk of death than those who are of normal weight but are out of shape. Death rates for those with higher fitness levels were less than half the rates for those who were unfit. This confirms earlier research that documented lower mortality levels in those who are physically active at present, not just in the past. 

What can help us and others become more active? A recent review (also in JAMA) on “Using pedo­meters to increase physical activity and improve health” concludes that pedometer use is associated with significant increases in physical activity as well as significant decreases in body mass index and blood pressure. 

Pedometer users increased their physical activity by almost 2500 steps per day more than control participants in randomized controlled trials. Overall pedometer users increased their physical activity by 26.9% over baseline. An important predictor of this was having a step goal such as 10000 steps per day. 

Doctors in BC will have opportunity in 2008 to promote pedo­meter use with their patients through the Healthy Living Alliance Walking initiative. This has been formalized and physicians will be part of making it happen. More information will be forthcoming as soon as this program rolls out across the province. So thanks to Dr Paffenberger for starting this work and let’s honor him by promoting physical activity among ourselves and our patients.

—Ron Wilson, MD
Chair, Athletics and Recreation Committee