Version 2/7/12
for Walking with Pedometer
Practical advice to implement the US Department of Health and
Human Services 2008 Physical Activity Guidelines for Americans
Suggestions when prescribing Rx for sedentary and unfit patients
Dose-response relations documented between volume of physical activity and health benefits
(summarized by Powell et al., 2011, pp. 353-354)
 There is no lower activity threshold for health benefits.
 The rate of risk reduction is greatest at the lowest end of the activity scale.
 In population-based studies, there is no apparent upper threshold where benefits begin to
diminish.
 There is no obvious single volume of activity to choose as a recommended level.
Recommendations are likely to vary from condition to condition.
Safely increasing the volume of physical activity (evidence-based recommendations paraphrased
from Powell et al., 2011, p. 357)
 There is little to no research on the proper beginning dose of activity for safely advancing one’s
activity level.
 It is important that people who are sedentary and unfit begin their program prudently.
 Increments should be small and time should be allowed for physiological adaption.
 Activity should be based on relative intensity, that is, relative to patient’s own baseline.
 Frequency and duration of activity should increase before intensity (i.e., speed of walking).
 New activities should have a relative intensity of light or moderate.
 Adding a 5-15 minute walk two to three days per week would be a reasonable beginning for
people who are unfit or old (citation: 2008 Physical Activity Guidelines Advisory Committee
Report, http://www.health.gov/paguidelines/Report/pdf/CommitteeReport.pdf).
 Building to 20-30 minutes per session for several weeks should be achieved before considering
an increase in relative intensity.
 Cardiovascular adaptation to an augmented activity regimen may take as long as 20 weeks or
more for older, suggesting that the elderly should increase their activity levels at monthly
rather than weekly intervals.
Conversion of steps and minutes to miles per hour (mph)
 2000 steps is about 1 mile
Minutes
10
15
20
30
Steps
An average stride is usually somewhere
between 2 and 3 feet in length. So on
average it takes between 1760 and
2640 steps to complete one mile.
http://www.thewalkingsite.com/faq.html
Source
Miles per hour
500
1000
1500
2000
3000
4000
1.5
3
4.5
1
2
3
4
0.75
1.5
2.25
3
4
0.5
1
1.5
2
3
4
Powell, K. E., Paluch, A. E., & Blair, S. N. (2011). Physical activity for health: What kind? How much? On top of what? Annual
Review of Public Health, Vol.32, 349-365.
Developed by: Linda S. Gottfredson, PhD, School of Education, University of Delaware, & Kathy Stroh, MS, RD, CDE,
Diabetes Prevention and Control Program, Delaware Division of Public Health (Dec 2008; Revised Jan 2012)
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