***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Recent systematic review s have suggested that pedometers may be effective motivational tools to promote walking . However , studies tend to be of a relatively short duration , with small clinical based sample s. Further research is required to demonstrate their effectiveness in adequately powered , community based studies . Objective Using a r and omized controlled trial design , this study assessed the impact of a 12-week graduated pedometer-based walking intervention on daily step-counts , self-reported physical activity and health outcomes in a Scottish community sample not meeting current physical activity recommendations . MethodS ixty-three women and 16 men ( 49.2 years ± 8.8 ) were r and omly assigned to either an intervention ( physical activity consultation and 12-week pedometer-based walking program ) or control ( no action ) group . Measures for step-counts , 7-day physical activity recall , affect , quality of life ( n = 79 ) , body mass , BMI , % body fat , waist and hip circumference ( n = 76 ) , systolic/diastolic blood pressure , total cholesterol and HDL cholesterol ( n = 66 ) were taken at baseline and week 12 . Analyses were performed on an intention to treat basis using 2-way mixed factorial analyses of variance for parametric data and Mann Whitney and Wilcoxon tests for non-parametric data . Results Significant increases were found in the intervention group for step-counts ( p < .001 ) , time spent in leisure walking ( p = .02 ) and positive affect ( p = .027 ) . Significant decreases were found in this group for time spent in weekday ( p = .003 ) , weekend ( p = .001 ) and total sitting ( p = .001 ) with no corresponding changes in the control group . No significant changes in any other health outcomes were found in either group . In comparison with the control group at week 12 , the intervention group reported a significantly greater number of minutes spent in leisure time ( p = .008 ) , occupational ( p = .045 ) and total walking ( p = .03 ) , and significantly fewer minutes in time spent in weekend ( p = .003 ) and total sitting ( p = .022 ) . Conclusion A pedometer-based walking program , incorporating a physical activity consultation , is effective in promoting walking and improving positive affect over 12 weeks in community based individuals . The discussion examines possible explanations for the lack of significant changes in health outcomes . Continued follow-up of this study will examine adherence to the intervention and possible result ing effects on health outcomes Background Age‐related endothelial dysfunction and vascular stiffening are associated with increased cardiovascular ( CV ) risk . Many groups have encouraged goals of ≥10 000 steps/day or ≥30 min/day of moderate intensity physical activity ( MPA ) to reduce age‐related CV risk . The impact of MPA on the vasculature of older adults remains unclear . Methods and Results We r and omized 114 sedentary older adults ages ≥50 to 12 weeks of either no intervention ( group 1 ) , a pedometer‐only intervention ( group 2 ) , or a pedometer with an interactive website employing strategies to increase the adoption of habitual physical activity ( PA , group 3 ) . Endothelial function by brachial flow‐mediated dilation ( FMD% ) , vascular stiffness by tonometry , step‐count by pedometer , and PA intensity/distribution by accelerometer were measured . Step‐count increased in groups 2 ( 5136±1554 to 9596±3907 , P<0.001 ) and 3 ( 5474±1512 to 8167±3111 , P<0.001 ) but not in group 1 ( 4931±1667 to 5410±2410 ) . Both groups 2 and 3 increased MPA ≥30 min/day . Only group 3 increased MPA in continuous bouts of ≥10 minutes ( P<0.001 ) and improved FMD% ( P=0.001 ) . Neither achievement of ≥10 000 steps/day nor ≥30 min/day of MPA result ed in improved FMD% . However , achieving ≥20 min/day in MPA bouts result ed in improved FMD% . No changes in vascular stiffness were observed . Conclusions MPA reverses age‐related endothelial dysfunction , but may require MPA to be performed in bouts of ≥10 minutes duration for ≥20 min/day to be effective . Commonly encouraged PA goals do not guarantee improved endothelial function and may not be as effective in reducing CV risk . Clinical Trial Registration URL : Clinical trials.gov . Unique identifier : NCT‐01212978 The aim of the study was to determine whether a recommendation to walk 10000 steps per day would result in significant improvements in glycemic control , insulin sensitivity , and cardiovascular risk in patients with type 2 diabetes mellitus . The study was a 6-week r and omized controlled trial that included 30 patients with type 2 diabetes mellitus . After 10 days of baseline activity , patients were r and omized into 2 groups : control and active . The control group ( n = 15 ) was instructed to continue with their baseline activity for 6 weeks . The active group ( n = 15 ) was instructed to walk at least 10000 steps per day 5 or more days per week , for 6 weeks .  Data relevant to glycemic control and other parameters of health were collected at study weeks 0 and 6 . There were no differences in the baseline activity between groups ( P = .36 ) . Subjects in the active group significantly increased physical activity by 69 % during the intervention phase of the study ( P = .002 ) , whereas there was no change in the physical activity of the control group ( P > .05 ) . High-density lipoprotein cholesterol and resting energy expenditure significantly increased in the active group ( P < .05 ) . Finally , plasminogen activator inhibitor 1 ( PAI-1 ) activity was reduced by exercise relative to the control group ( P = .03 ) . There were no differences in any other study parameters during the 6-week study . In conclusion , short-term intervention with a pedometer increased physical activity and positively affected plasminogen activator inhibitor 1 activity in previously inactive patients with type 2 diabetes mellitus . The use of a pedometer may prove to be an effective tool for promoting healthy lifestyle changes that include daily physical activity and self-monitoring of therapeutic goals PURPOSE The American College of Sports Medicine and the Centers for Disease Control and Prevention ( ACSM-CDC ) recommend 30 min of daily moderate-intensity physical activity for health ; however , the effectiveness of this recommendation in lowering blood pressure ( BP ) in hypertensives is unclear . The present study tested the hypothesis that walking activity following the ACSM-CDC physical activity recommendation would lower BP in postmenopausal women with high BP . METHODS Resting BP was measured in 24 postmenopausal women with borderline to stage 1 hypertension at baseline , 12 wk , and 24 wk . Fifteen women in the  exercise ( EX ) group walked 3 km.d-1 above their daily lifestyle walking , whereas 9 women in the control ( CON ) group did not change their activity . Walking activity was self-measured with a pedometer in both groups . RESULTS Resting systolic BP was reduced in the EX group after 12 wk by 6 mm Hg ( P < 0.005 ) and was further reduced by 5 mm Hg at the end of 24 wk ( P < 0.005 ) . There was no change in diastolic BP with walking . The CON group experienced no change in BP at either 12 or 24 wk . Body mass was modestly reduced by 1.3 kg in the EX group after 24 wk ( P < 0.05 ) ; however , it was not correlated with the change in BP . There were no changes in selected variables known to impact BP including percent body fat , fasting plasma insulin , or dietary intake . CONCLUSION In conclusion , a 24-wk walking program meeting the ACSM-CDC physical activity recommendation is effective in lowering systolic BP in postmenopausal women with borderline to stage 1 hypertension Background A significant proportion of Europeans do not meet the recommendations for 30 mins of physical activity 5 times per week . Whether lower frequency , moderate intensity exercise alters cardiovascular disease ( CVD ) risk has received little attention . This study examined the effects of 45 minutes self-paced walking , 2 d · wk-1 on aerobic fitness , blood pressure ( BP ) , body composition , lipids and C-Reactive Protein ( CRP ) in previously sedentary civil servants . Methods 37 subjects ( 24 women ) aged 41.5 ± 9.3 years were r and omly assigned to either two 45 minute walks per week ( walking group ) or no training ( control group ) . Aerobic fitness , body composition , blood pressure ( BP ) , CRP and lipoprotein variables were measured at baseline and following 8 weeks . Steps counts were measured at baseline and during weeks 4 and 8 of the intervention . Results Compared to the control group , the walking group showed a significant reduction in systolic BP and maintained body fat levels ( P < 0.05 ) . There were no changes other risk factors . Subjects took significantly more steps on the days when prescribed walking was performed ( 9303 ± 2665 ) compared to rest days ( 5803 ± 2749 ; P < 0.001 ) . Conclusion These findings suggest that walking twice per week for 45 minutes at ~ 62 % HRmax , improves activity levels , reduces systolic BP and prevents an increase in body fat in previously sedentary adults .  This walking prescription , however , failed to induce significant improvements in other markers of cardiovascular disease risk following eight weeks of training OBJECTIVE : To conduct a r and omised trial of a physical activity ( PA ) intervention , The First Step Program ( FSP ) for adults with type II diabetes . DESIGN : A 16-week intervention study and 24-week follow-up assessment . PARTICIPANTS : A total of 47 overweight/obese , sedentary individuals ( age=52.7±5.2 y ; BMI = 33.3±5.6 kg/m2 ) recruited through a diabetes education centre . MEASUREMENTS : Primary outcome :  daily PA assessed by pedometer ( steps/day ) . Secondary outcomes : anthropometric measures ( weight , BMI , waist girth , hip girth ) ; indicators of cardiovascular health ( resting heart rate and blood pressure ) ; glycemic control ( fasting glucose , insulin , HbA1c , glucose concentration 120 min postglucose load ) ; plasma lipid status ( total cholesterol , HDL cholesterol , LDL cholesterol , and triglycerides ) . RESULTS : Relative to the CONTROL group , FSP participants increased  their PA > 3000 steps/day ( approximately 30 min/day ) during the intervention ( P<0.0001 ) . Waist and hip girth decreased ( approximately 2–3 cm ) , but did not differ significantly between groups . Significant changes did not emerge for any of the other variables . CONCLUSIONS : The FSP is a practical intervention that elicits an immediate and profound change in walking behaviour . Such change is an important ‘ first step ’ towards increasing the volume and /or intensity of PA necessary to improve long-term health outcomes in this largely sedentary and overweight or obese population . Relapse by 24 weeks indicates that other strategies such as booster sessions are needed to maintain lifestyle change . Further research must determine realistic and responsive health outcomes for this population that are achievable through practical , real-world programming BACKGROUND Recent public health initiatives have promoted accumulating 10,000 steps per day . Little previous research has evaluated its effects in young adults . The aim of this study was to determine the effects of taking 10,000 steps per day on fitness and cardiovascular risk factors in sedentary university students . METHODS Healthy , sedentary students ( mean age 21.16 ± SD 6.17 ) were r and omly allocated to take 10,000 steps per day or to a control group who maintained their habitual activity . Members of the 10,000 step group wore a pedometer and reported daily step count in a diary . Outcome measurements ( 20-meter multistage shuttle run , BMI , and blood pressure ) were measured before and after 6 weeks . RESULTS There were no significant differences between the groups at baseline . After 6 weeks , the 10,000 steps group were taking significantly more steps ( 8824.1 ± SD 5379.3 vs. 12635.9 ± SD 6851.3 ; P = .03).No changes were observed in fitness , or BMI ( P > .05 ) . Significant reductions in blood pressure ( P = .04 ) in the 10,000 step group . CONCLUSIONS A daily target of 10,000 steps may be an appropriate intervention in sedentary university students to increase their physical activity levels . The positive health benefits of simple everyday physical activity should be promoted among health professionals St and ardised data on blood pressure , 24 hour urinary electrolyte excretion and other lifestyle factors were obtained in three Japanese population s as part of the INTERSALT study . Urinary sodium excretion and sodium/potassium ratio were significantly ( P less than 0.01 ) higher in Toyama ( a semi-rural area in central Japan ) than in Tochigi ( a rural area 100 km north of Tokyo ) and Osaka . There were also significant ( P less than 0.01 ) differences between the centres in 
    Output:
    
However , net change in systolic BP was not associated with the step count in an intervention group following the intervention .
At present , there is presumably no evidence that walking 10,000 steps a day lowers the BP to any marked degree .