Older adults and special populations (living with disability and/or chronic illness that may limit mobility and/or physical endurance) can benefit from practicing a more physically active lifestyle, typically by increasing ambulatory activity. Step counting devices (accelerometers and pedometers) offer an opportunity to monitor daily ambulatory activity; however, an appropriate translation of public health guidelines in terms of steps/day is unknown. Therefore this review was conducted to translate public health recommendations in terms of steps/day. Normative data indicates that 1) healthy older adults average 2,000-9,000 steps/day, and 2) special populations average 1,200-8,800 steps/day. Pedometer-based interventions in older adults and special populations elicit a weighted increase of approximately 775 steps/day (or an effect size of 0.26) and 2,215 steps/day (or an effect size of 0.67), respectively. There is no evidence to inform a moderate intensity cadence (i.e., steps/minute) in older adults at this time. However, using the adult cadence of 100 steps/minute to demark the lower end of an absolutely-defined moderate intensity (i.e., 3 METs), and multiplying this by 30 minutes produces a reasonable heuristic (i.e., guiding) value of 3,000 steps. However, this cadence may be unattainable in some frail/diseased populations. Regardless, to truly translate public health guidelines, these steps should be taken over and above activities performed in the course of daily living, be of at least moderate intensity accumulated in minimally 10 minute bouts, and add up to at least 150 minutes over the week. Considering a daily background of 5,000 steps/day (which may actually be too high for some older adults and/or special populations), a computed translation approximates 8,000 steps on days that include a target of achieving 30 minutes of moderate-to-vigorous physical activity (MVPA), and approximately 7,100 steps/day if averaged over a week. Measured directly and including these background activities, the evidence suggests that 30 minutes of daily MVPA accumulated in addition to habitual daily activities in healthy older adults is equivalent to taking approximately 7,000-10,000 steps/day. Those living with disability and/or chronic illness (that limits mobility and or/physical endurance) display lower levels of background daily activity, and this will affect whole-day estimates of recommended physical activity.

While there are quite consistent data regarding associations of body weight and postmenopausal breast cancer, there are now accumulating data that would indicate that weight gain in adult life is more predictive of risk than absolute body weight. There is, however, little known about the relative impact of timing of weight gain in adult life as well as other characteristics of the weight and breast cancer association that might provide insight into the mechanism of the observation. We conducted a population-based case control study of breast cancer (1996)(1997)(1998)(1999)(2000)(2001), the Western New York Exposures and Breast Cancer Study. Included were 1,166 women with primary, histologically confirmed, incident breast cancer and 2,105 controls frequency-matched on age, race and county of residence. Unconditional logistic regression was used to estimate odds ratios and 95% confidence intervals. We found increased risk of breast cancer associated with lifetime adult weight gain among post-but not premenopausal women, and there was a 4% increase in risk for each 5 kg increase in adult weight. Further there was a tendency toward a stronger association for those with higher waist circumference and those with positive estrogen or progesterone status, and who had never used HRT. We also found an association with risk for weight gain since first pregnancy and for weight gain between the time of the first pregnancy and menopause, independent of body mass index and lifetime adult weight gain. Our results suggest that there are time periods of weight gain that have greater impact on risk, and that central body fat, receptor status and hormone replacement therapy may all affect the observed association. ' 2006 Wiley-Liss, Inc.Key words: breast cancer; weight gain; epidemiology; case-control study Numerous epidemiologic studies of the relationship between body size and breast cancer risk have been conducted to examine its potential role as a modifiable risk factor, independent of dietary intake and physical activity.1-4 Although our ability to explain the mechanism of the observed association is still limited, there is quite consistent evidence showing an association of indicators of body size and postmenopausal breast cancer. In particular, body mass index (BMI) and central adiposity have been shown to be associated with increased risk of post-but not premenopausal breast cancer. [5][6][7][8][9] There are now accumulating data that would indicate that weight gain in adult life is more predictive of risk than absolute body weight or BMI. [10][11][12][13][14][15] There is, however, little known about the timing of weight gain in adult life as well as other characteristics of the weight and breast cancer association that might provide insight into the mechanism of the observation. There is interest in weight gain during particular periods of life, especially weight gain during periods of hormonal changes, such as pregnancy and menopause. 4,16,17 Understanding of timing of weight gain in relation to risk could provide insigh...

Limited information is available regarding physical activity (PA) and its assessment in Hispanics living with HIV. This study compared self-reported PA using the International Physical Activity Questionnaire (IPAQ) with objectively measured PA using the ActiGraph accelerometer and DigiWalker pedometer in 58 Hispanic adults with HIV. IPAQ was administered before and after a 7-day period in which subjects wore the ActiGraph and DigiWalker. PA classification was based on > or = 150 min/wk (IPAQ, ActiGraph) and > or = 10,000 steps/day (DigiWalker). IPAQ-PA was higher than ActiGraph-PA (423 +/- 298 vs. 165 +/- 134 min/wk, respectively) (p < .01). There was a mismatch in PA classification with the IPAQ, ActiGraph, and DigiWalker (active = 81%, 54%, and 17%, respectively). Hispanics with HIV highly overestimated self-reported PA. Nurse scientists and other investigators must consider accelerometers or pedometers to assess PA in this population.

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