Daily steps are low year-round and dip lower in fall/winter: findings from a longitudinal diabetes cohort
Bibliographic record
Abstract
BACKGROUND: Higher walking levels lead to lower mortality in type 2 diabetes, but inclement weather may reduce walking. In this patient population, we conducted a longitudinal cohort study to objectively quantify seasonal variations both in walking and in two vascular risk factors associated with activity levels, hemoglobin A1C and blood pressure. METHODS: Between June 2006 and July 2009, volunteer type 2 diabetes patients in Montreal, Quebec, Canada underwent two weeks of pedometer measurement up to four times over a one year follow-up period (i.e. once/season). Pedometer viewing windows were concealed (snap-on cover and tamper proof seal). A1C, blood pressure, and anthropometric parameters were also assessed. Given similarities in measures for spring/summer and fall/winter, and because not all participants completed four assessments, spring and summer values were collapsed as were fall and winter values. Mean within-individual differences (95% confidence intervals) were computed for daily steps, A1C, and systolic and diastolic blood pressure, by subtracting spring/summer values from fall/winter values. RESULTS: Among 201 participants, 166 (82.6%) underwent at least one fall/winter and one spring/summer evaluation. Approximately half were women, the mean age was 62.4 years (SD 10.8), and the mean BMI was 30.1 kg/m2 (SD 5.7). Step counts averaged at a sedentary level in fall/winter (mean 4,901 steps/day, SD 2,464) and at a low active level in spring/summer (mean 5,659 steps/day, SD 2,611). There was a -758 (95% CI: -1,037 to -479) mean fall/winter to spring/summer within-individual difference. There were no significant differences in A1C or in anthropometric parameters. Systolic blood pressure was higher in fall/winter (mean 137 mm Hg, SD 16) than spring/summer (133 mm Hg, SD 14) with a mean difference of 4.0 mm Hg (95% CI: 2.3 to 5.7). CONCLUSIONS: Daily step counts in type 2 diabetes patients are low, dipping lower during fall/winter. In this medication-treated cohort, A1C was stable year-round but a fall/winter systolic blood pressure increase was detected. Our findings signal a need to develop strategies to help patients increase step counts year-round and prevent both reductions in step counts and increases in blood pressure during the fall and winter.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".