PURPOSE: to investigate associations between 4-yr change in step cadence and markers of cardiometabolic health in people with a history of prediabetes and to explore whether these associations are modified by demographic factors. METHODS: in this prospective cohort study, adults, with a history of prediabetes, were assessed for markers of cardiometabolic health (body mass index, waist circumference, high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], triglycerides, and glycated hemoglobin A1c [HbA1c]), and free-living stepping activity (activPAL3™) at baseline, 1 yr, and 4 yr. Brisk steps per day were defined as the number of steps accumulated at ≥100 steps per minute and slow steps per day as those accumulated at

BACKGROUND: a step cadence of 100 steps/minute is widely used to define moderate-intensity walking. However, the generalizability of this threshold to different populations needs further research. We investigate moderate-intensity step cadence values during treadmill walking and daily living in older adults. METHODS: Older adults (≥ 60 years) were recruited from urban community venues. Data collection included 7 days of physical activity measured by an activPAL3™ thigh worn device, followed by a laboratory visit involving a 60-min assessment of resting metabolic rate, then a treadmill assessment with expired gas measured using a breath-by-breath analyser and steps measured by an activPAL3™. Treadmill stages were undertaken in a random order and lasted 5 min each at speeds of 1, 2, 3, 4 and 5 km/h. Metabolic equivalent values were determined for each stage as standardised values (METSstandard) and as multiples of resting metabolic rate (METSrelative). A value of 3 METSstandard defined moderate-intensity stepping. Segmented generalised estimating equations modelled the association between step cadence and MET values. RESULTS: the study included 53 participants (median age = 75, years, BMI = 28.0 kg/m2, 45.3% women). At 2 km/h, the median METSstandard and METSrelative values were above 3 with a median cadence of 81.00 (IQR 72.00, 88.67) steps/minute. The predicted cadence at 3 METSstandard was 70.3 (95% CI 61.4, 75.8) steps/minute. During free-living, participants undertook median (IQR) of 6988 (5933, 9211) steps/day, of which 2554 (1297, 4456) steps/day were undertaken in continuous stepping bouts lasting ≥ 1 min. For bouted daily steps, 96.4% (90.7%, 98.9%) were undertaken at ≥ 70 steps/minute. CONCLUSION: a threshold as low as 70 steps/minute may be reflective of moderate-intensity stepping in older adults, with the vast majority of all bouted free-living stepping occurring above this threshold.

This study investigated associations between step cadence and physical function in healthy South Asian (SA) and White European (WE) older adults, aged ≥60. Participants completed the 60-s Sit-to-Stand (STS-60) test of physical function. Free-living stepping was measured using the activPAL3™. Seventy-one WEs (age = 72 ± 5, 53% male) and 33 SAs (age = 71 ± 5, 55% male) were included. WEs scored higher than SAs in the STS-60 (23 vs 20 repetitions, p = 0.045). Compared to WEs, SAs had significantly lower total and brisk (≥100 steps/min) steps (total: 8971 vs 7780 steps/day, p = 0.041; brisk: 5515 vs 3723 steps/day, p = 0.001). In WEs, 1000 brisk steps and each decile higher proportion of steps spent brisk stepping were associated with STS-60 (β = 0.72 95% CI 0.05, 1.38 and β = 1.01 95% CI 0.19, 1.82, respectively), with associations persisting across mean peak 1 min (β = 1.42 95% CI 0.12, 2.71), 30 min (β = 1.71 95% CI 0.22, 3.20), and 60 min (β = 2.16 95% CI 0.62, 3.71) stepping periods. Associations were not observed in SAs. Ethnic differences in associations between ambulation and physical function may exist in older adults which warrant further investigationi.