Effects of meeting steps-based and minutes-based physical activity goals on weight loss in online behavioral weight control: seemingly unrelated regression analysis

Melissa L Stansbury; Rebecca A Krukowski; Wen You; Jean R Harvey; Delia S West

doi:10.1080/21642850.2022.2129654

Effects of meeting steps-based and minutes-based physical activity goals on weight loss in online behavioral weight control: seemingly unrelated regression analysis

Health Psychol Behav Med. 2022 Oct 3;10(1):956-972. doi: 10.1080/21642850.2022.2129654. eCollection 2022.

Authors

Melissa L Stansbury¹, Rebecca A Krukowski², Wen You², Jean R Harvey³, Delia S West¹

Affiliations

¹ Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.
² Department of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, VA, United States.
³ Department of Nutrition and Food Sciences, College of Agriculture and Life Sciences, University of Vermont, Burlington, VT, United States.

Abstract

Background: Behavioral weight loss programs often prescribe physical activity (PA) goals in terms of minutes/week of moderate-to-vigorous PA (MVPA) and steps/day. However, the impact of meeting each type of goal prescription on weight loss is unclear, particularly in digitally-based (eHealth/mHealth) programs. This secondary analysis of a randomized trial examined the effects of meeting steps-based and minutes-based goals on weight loss in an eHealth behavioral weight control program.

Methods: Adults in the control arm received a 6-month online behavioral weight loss intervention with prescribed weekly goals for daily steps and minutes of MVPA. The number of weeks steps-based and minutes-based goals were met (≥100% and ≥75% thresholds) based on self-reported PA were examined as predictors of 6-month weight loss among those providing weight outcomes (n = 172; 81% of control arm) using a systems regression approach.

Results: Participants (BMI 35.6 kg/m²; 90.1% female; 48.7 years of age) met weekly goals for MVPA (7.1 ± 6.4 weeks) more often than steps (3.5 ± 5.5 weeks, P < .001). Meeting the steps goals (β = .24, P < .001) and MVPA goals (β = .20, P < .001) were each statistically significant predictors of weight loss at the 100% threshold; their total effects were not statistically different from one another (χ ² = 1.12, P = .29). Similarly, at the 75% threshold for steps goals (β = .19, P < .001) and MVPA goals (β = .19, P < .001), each independently predicted weight loss; no differences were detected in their total effects (χ² = .01, P = .92). The probability of reaching ≥5% weight loss was comparable between meeting the steps goals and MVPA goals at both adherence thresholds.

Conclusions: Greater attainment of PA goals prescribed as steps and minutes of MVPA independently contribute to similar weight loss outcomes in a 6-month online behavioral weight loss intervention. Future research should determine whether promoting adherence to combined steps-based and minutes-based goals produces better weight loss than utilizing either goal alone and identify strategies that improve adherence.

Keywords: Exercise prescription; health behavior; interventions; obesity; physical activity.

Grants and funding

R01 DK056746/DK/NIDDK NIH HHS/United States