The metabolic energy cost of walking is determined, to a large degree, by body mass, but it is not clear how body composition and mass distribution influence this cost. We tested the hypothesis that walking would be most expensive for obese women compared with obese men and normal-weight women and men. Furthermore, we hypothesized that for all groups, preferred walking speed would correspond to the speed that minimized the gross energy cost per distance. We measured body composition, maximal oxygen consumption, and preferred walking speed of 39 (19 class II obese, 20 normal weight) women and men. We also measured oxygen consumption and carbon dioxide production while the subjects walked on a level treadmill at six speeds (0.50-1.75 m/s). Both obesity and sex affected the net metabolic rate (W/kg) of walking. Net metabolic rates of obese subjects were only approximately 10% greater (per kg) than for normal-weight subjects, and net metabolic rates for women were approximately 10% greater than for men. The increase in net metabolic rate at faster walking speeds was greatest in obese women compared with the other groups. Preferred walking speed was not different across groups (1.42 m/s) and was near the speed that minimized gross energy cost per distance. Surprisingly, mass distribution (thigh mass/body mass) was not related to net metabolic rate, but body composition (% fat) was (r2= 0.43). Detailed biomechanical studies of walking are needed to investigate whether obese individuals adopt novel energy saving mechanisms during walking.

Distal leg loads increase the metabolic rate required for swinging the leg. The increase in metabolic rate with more proximal loads may be attributable to a combination of supporting (via hip abduction muscles) and propagating the swing leg.

Greater sagittal-plane knee moments in the obese subjects suggest that they walked with greater knee-joint loads than normal-weight adults. Walking slower reduced GRF and net muscle moments and may be a risk-lowering strategy for obese adults who wish to walk for exercise. When obese subjects walked at 1.0 versus 1.5 m.s(-1), peak sagittal-plane knee moments were 45% less. Obese subjects walking at approximately 1.1 m.s(-1) would have the same absolute peak sagittal-plane knee net muscle moment as normal-weight subjects when they walk at their typical preferred speed of 1.4 m.s(-1).

BROWNING, RAYMOND C. AND RODGER KRAM. Energetic cost and preferred speed of walking in obese vs. normal weight women. Obes Res. 2005;13:891-899. Objective: We tested the hypotheses that walking is more expensive for obese women, and they prefer slower walking speeds that minimize the gross energy cost per distance despite a greater relative aerobic effort [percent of maximal oxygen uptake (V O 2max )/kg]. Research Methods and Procedures: Twenty adult women, 10 obese (BMI ϭ 34.1 Ϯ 3.2 kg/m 2 ) and 10 normal weight (BMI ϭ 20.4 Ϯ 2.1 kg/m 2 ) volunteered. To determine the metabolic rate and energy cost per distance vs. speed relationships, we measured V O 2 and V CO 2 while subjects walked on a treadmill at six speeds (0.50, 0.75, 1.0, 1.25, 1.5, and 1.75 m/s; 5-minute trials, with a 5-minute rest period between trials). We measured preferred walking speed on a 50-m section of level sidewalk and V O 2max using a modified Balke treadmill protocol. Results: Walking was 11% more expensive for the obese subjects, but they preferred to walk at similar speeds as normal weight subjects (1.40 vs. 1.47 m/s, p ϭ 0.07). Both groups preferred walking speeds at which their gross energy cost per distance was almost minimized. Obese subjects had a smaller V O 2max /kg, so they required a greater relative aerobic effort at the preferred speed (51% vs. 36%, p ϭ 0.001). Discussion: Obese women preferred a walking speed that minimized energy cost per distance, even though this strategy required a greater relative aerobic effort than walking more slowly. Our results suggest that walking slower for a set distance may be an appropriate exercise recommendation for a weight management prescription in obese adults.

Despite significant efforts, obesity continues to be a major public health problem, and there are surprisingly few effective strategies for its prevention and treatment. We now realize that healthy diet and activity patterns are difficult to maintain in the current physical environment. Recently, it was suggested that the social environment also contributes to obesity. Therefore, using network‐based interaction models, we simulate how obesity spreads along social networks and predict the effectiveness of large‐scale weight management interventions. For a wide variety of conditions and networks, we show that individuals with similar BMIs will cluster together into groups, and if left unchecked, current social forces will drive these groups toward increasing obesity. Our simulations show that many traditional weight management interventions fail because they target overweight and obese individuals without consideration of their surrounding cluster and wider social network. The popular strategy for dieting with friends is shown to be an ineffective long‐term weight loss strategy, whereas dieting with friends of friends can be somewhat more effective by forcing a shift in cluster boundaries. Fortunately, our simulations also show that interventions targeting well‐connected and/or normal weight individuals at the edges of a cluster may quickly halt the spread of obesity. Furthermore, by changing social forces and altering the behavior of a small but random assortment of both obese and normal weight individuals, highly effective network‐driven strategies can reverse current trends and return large segments of the population to a healthier weight.

Understanding degeneration of biological and prosthetic knee joints requires knowledge of the in-vivo loading environment during activities of daily living. Musculoskeletal models can estimate medial/lateral tibiofemoral compartment contact forces, yet anthropometric differences between individuals make accurate predictions challenging. We developed a full-body OpenSim musculoskeletal model with a knee joint that incorporates subject-specific tibiofemoral alignment (i.e. knee varus-valgus) and geometry (i.e. contact locations). We tested the accuracy of our model and determined the importance of these subject-specific parameters by comparing estimated to measured medial and lateral contact forces during walking in an individual with an instrumented knee replacement and post-operative genu valgum (6°). The errors in the predictions of the first peak medial and lateral contact force were 12.4% and 11.9%, respectively, for a model with subject-specific tibiofemoral alignment and contact locations determined via radiographic analysis, vs. 63.1% and 42.0%, respectively, for a model with generic parameters. We found that each degree of tibiofemoral alignment deviation altered the first peak medial compartment contact force by 51N (r2=0.99), while each millimeter of medial-lateral translation of the compartment contact point locations altered the first peak medial compartment contact force by 41N (r2=0.99). The model, available at www.simtk.org/home/med-lat-knee/, enables the specification of subject-specific joint alignment and compartment contact locations to more accurately estimate medial and lateral tibiofemoral contact forces in individuals with non-neutral alignment.

Walking is a recommended form of exercise for the treatment of obesity, but walking may be a critical source of biomechanical loads that link obesity and musculoskeletal pathology, particularly knee osteoarthritis. We hypothesized that compared with normal-weight adults 1) obese adults would have greater absolute ground-reaction forces (GRF) during walking, but their GRF would be reduced at slower walking speeds; and 2) obese adults would have greater sagittal-plane absolute leg-joint moments at a given walking speed, but these moments would be reduced at slower walking speeds. Methods: We measured GRF and recorded sagittal-plane kinematics of 20 adults (10 obese and 10 normal weight) as they walked on a level, forcemeasuring treadmill at six speeds (0.5-1.75 mIs j1). We calculated sagittal-plane net muscle moments at the hip, knee, and ankle. Results: Compared with their normal-weight peers, obese adults had much greater absolute GRF (N), stance-phase sagittal-plane net muscle moments (NIm) and step width (m). Conclusions: Greater sagittal-plane knee moments in the obese subjects suggest that they walked with greater knee-joint loads than normal-weight adults. Walking slower reduced GRF and net muscle moments and may be a risk-lowering strategy for obese adults who wish to walk for exercise. When obese subjects walked at 1.0 versus 1.5 mIs j1 , peak sagittal-plane knee moments were 45% less. Obese subjects walking at approximately 1.1 mIs j1 would have the same absolute peak sagittal-plane knee net muscle moment as normal-weight subjects when they walk at their typical preferred speed of 1.4 mIs j1 .

Monitoring of posture allocations and activities enables accurate estimation of energy expenditure and may aid in obesity prevention and treatment. At present, accurate devices rely on multiple sensors distributed on the body and thus may be too obtrusive for everyday use. This paper presents a novel wearable sensor, which is capable of very accurate recognition of common postures and activities. The patterns of heel acceleration and plantar pressure uniquely characterize postures and typical activities while requiring minimal preprocessing and no feature extraction. The shoe sensor was tested in nine adults performing sitting and standing postures and while walking, running, stair ascent/descent and cycling. Support vector machines (SVMs) were used for classification. A fourfold validation of a six-class subject-independent group model showed 95.2% average accuracy of posture/activity classification on full sensor set and over 98% on optimized sensor set. Using a combination of acceleration/pressure also enabled a pronounced reduction of the sampling frequency (25 to 1 Hz) without significant loss of accuracy (98% versus 93%). Subjects had shoe sizes (US) M9.5-11 and W7-9 and body mass index from 18.1 to 39.4 kg/m2 and thus suggesting that the device can be used by individuals with varying anthropometric characteristics.