ACC: 'Stepping' Up Competition Is Key to Lifestyle Improvement

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CHICAGO -- Tapping into patients' competitive spirit appears to be an effective way to motivate them to increase exercise and lose weight -- and by using web-based tools, the competition can be global.

That finding emerged from analysis of data collected from more than 69,000 participants in Stepathlon, a 100-day global competition conducted in 2012, 2013, and 2014, in which teams from participating employers are urged to compete against each other by meeting or exceeding daily step goals.

Steps were measured by pedometers given to participants, and progress was tracked using an interactive multi-platform app.

The "study was conducted as a pre-post cohort design ... Study data were collected electronically via questionnaires at initial registration, and at completion of the 100-day Stepathlon event," the researchers reported.

"I think competition is an important motivator, more effective than simply talking to the patient and handing out pedometers," said Anand Ganesan, MBBS, PhD, of Flinders University in Adelaide, Australia, in an interview.

Ganesan reported the findings of the Stepathlon study at the American College of Cardiology meeting here. The findings were also published by the Journal of the American College of Cardiology.

"Our study suggests that by using technology in a clever way, perhaps we, as a community, can devise solutions to this problem," he said in a statement.

A major criticism of interventions such as Stepathalon is that they don't provide long term results, "but that is really not possible because technology in these apps changes too rapidly," Ganesan asserted.

As an alternative, "we repeated the 'study' three times, three 100 day interventions, and each time the results were the same," he said.

The results were also impressive each time:

• Improved step count (+3,519 steps/day, 95% CI 3,484-3,553, P<0.0001)
• Increased exercise days (+0.89 days, 95% CI 0.87-0.92, P<0.0001)
• Decreased sitting duration (-0.74 hrs, 95% CI -0.78 to -0.71, P<0.0001)
• Weight reduction (-1.45 kg, 95% CI -1.53 to -1.38, P<0.0001)

Moreover, the improvements were observed in both men and women, in all geographic regions, and at both high and middle income levels.

The study participants represented 64 countries, with 481 employers in 1,481 cities. Their average age was 37, and 24% were women.

"This is a low-cost intervention that can address entire populations, Ganesan said.