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Background: Best-practice early interventions to increase physical activity (PA) in children with overweight and obesity should be both feasible and evidence based. Walking is a basic human movement pattern that is practical, cost-effective, and does not require complex movement skills. However, there is still a need to investigate how much walking-as a proportion of total PA level-is performed by children who are overweight and obese in order to determine its utility as a public health strategy. Objective: This study aimed to (1) investigate the proportion of overall PA indicators that are explained by step-based metrics and (2) study step accumulation patterns relative to achievement of public health recommendations in children who are overweight and obese. Methods: A total of 105 overweight and obese children (mean 10.1 years of age [SD 1.1]; 43 girls) wore hip-worn accelerometers for 7 days. PA volumes were derived using the daily average of counts per 15 seconds, categorized using standard cut points for light-moderate-vigorous PA (LMVPA) and moderate-to-vigorous PA (MVPA). Derived step-based metrics included volume (steps/day), time in cadence bands, and peak 1-minute, 30-minute, and 60-minute cadences. Results: Steps per day explained 66%, 40%, and 74% of variance for counts per 15 seconds, LMVPA, and MVPA, respectively. The variance explained was increased up to 80%, 92%, and 77% by including specific cadence bands and peak cadences. Children meeting the World Health Organization recommendation of 60 minutes per day of MVPA spent less time at zero cadence and more time in cadence bands representing sporadic movement to brisk walking (ie, 20-119 steps/min) than their less-active peers. Conclusions: Step-based metrics, including steps per day and various cadence-based metrics, seem to capture a large proportion of PA for children who are overweight and obese. Given the availability of pedometers, step-based metrics could be useful in discriminating between tho, Funding Agencies|MINECO (Ministerio de Economia y COmpetitividad)/FEDER (Fondo Europeo de DEsarrollo Regional) [DEP2013-47540, DEP2016-79512-R, RYC-2011-09011]; Spanish Ministry of Education, Culture and Sport [FPU15/02645, FPU14/06837]; Spanish Ministry of Economy and Competitiveness [BES-2014-068829]; European UnionEuropean Union (EU) [667302]; University of Granada, Plan Propio de Investigacion 2016, Excellence action: Units of Excellence; University of Granada, Plan Propio de Investigacion 2016, Excellence action: Unit of Excellence on Exercise and Health (UCEES); Junta de AndaluciaJunta de Andalucia [SOMM17/6107/UGR, RD16/0022]; Consejeria de Conocimiento, Investigacion y Universidades [SOMM17/6107/UGR, RD16/0022]; European Regional Development Fund (ERDF)European Union (EU) [SOMM17/6107/UGR, RD16/0022]; SAMID III (red de SAlud Materno Infantil y Desarrollo) network, RETICS (REdes Tematicas de Investigacion Cooperativa en Salud) - PN (Plan Nacional) I+D+I (Investigacion + Desarrollo + Innovacion) 2017-2021 (Spain); ISCIII (Instituto de Salud Carlos III)-Sub-Directorate General for Research Assessment and Promotion [DEP2005-00046/ACTI]; EXERNET Research Network on Exercise and Health in Special Populations [DEP2005-00046/ACTI]; European Unions 2020 research and innovation programEuropean Union (EU) [667302]; Intramural Research Program at the National Institute on Aging, USA

Office-based activity reduces sedentariness, yet no randomized controlled trials (RCTs) have assessed how such activity influences visceral adipose tissue (VAT). This study examined the effect of an office-based, multicomponent activity intervention on VAT. The WorkACTIVE-P RCT enrolled sedentary office workers (body mass index: 31.4 (standard deviation (SD) 4.4) kg/m2) to an intervention (n = 20) or control (n = 20) group. For 3 months, the intervention group received an office-based pedal desk, further to an intervention promoting its use and increased walking. The control group maintained habitual activity. At baseline and follow-up, VAT, cardiometabolic disease risk markers, physical activity, and food intake were measured. Steps/day were not altered relative to control (P ≥ 0.51), but the pedal desk was utilized for 127 (SD 61) min/day. The intervention reduced VAT relative to control (-0.15 kg; 95% confidence interval (CI) = -0.29 to -0.01; P = 0.04). Moreover, the intervention decreased fasting glucose compared with control (-0.29 mmol/L; 95% CI = -0.51 to -0.06; P = 0.01), but no differences in other cardiometabolic disease markers or food intake were revealed (P ≥ 0.11). A multicomponent intervention decreased VAT in office workers who were overweight or obese. Though longer-term studies are needed, office-based, multicomponent activity regimens may lower cardiometabolic disease risk. Trial registered at ClinicalTrials.gov (NCT02561611). Novelty: In WorkACTIVE-P, a multicomponent activity intervention decreased visceral adipose tissue relative to control in office workers. The intervention also reduced glucose compared with control, though other metabolic risk markers and food intake were not altered. Such multicomponent interventions could help reduce cardiometabolic disease risk, but longer studies are needed.