title: Feasibility of adding enhanced pedometer feedback to nutritional counseling for weight loss.
abstract: BACKGROUND
  Intensive interventions targeting diet and physical activity are effective for weight reduction but are costly. Tailored, computer-generated, step-count feedback may provide an intensive and affordable way to increase the physical activity of people at high risk for cardiovascular disease.
  
  
  OBJECTIVE
  The objective was to test the feasibility of adding tailored, computer-generated, step-count feedback to a face-to-face nutritional counseling weight loss intervention.
  
  
  METHODS
  We recruited 12 participants, 4 from each of three Department of Veterans Affairs medical centers. There were 11 male participants and 1 female participant. Each had a body mass index of 30 or greater and at least one of the following cardiovascular disease risk factors: diabetes, hypertension, hypercholesterolemia, obesity, or coronary artery disease. Participants attended one-on-one counseling sessions with a registered dietitian for four sessions over three weeks. At the initial session, each participant received an enhanced pedometer to record time-stamped, step-count data. Participants wore the device daily throughout the intervention. At the three follow-up sessions, the dietitian uploaded the computer data, reviewed a Web-based graphical display of step-count feedback, and helped set new walking goals.
  
  
  RESULTS
  All 12 participants completed the program (100% attendance). Initial mean weight was 255 lbs (SD = 49 lbs), and weight loss was just over 4 lbs (n = 12, paired t test, P = .004). Mean daily step counts during the first week averaged 6019 steps per day, increasing to an average of 7358 per day after the third week (average increase of 1339 steps per day, or 0.6 miles, or 12 minutes of walking, n = 10, paired t test, P = .04).
  
  
  CONCLUSIONS
  Enhanced pedometer feedback in conjunction with nutritional counseling is feasible and results in significant weight loss and increased walking among individuals at high risk for cardiovascular disease.
authors.affiliation: Veterans Affairs Medical Center and University of Michigan Health Systems, Department of Family Medicine, Ann Arbor, MI 48109-0708, USA. caroli@umich.edu
authors.forename: Caroline R
authors.initials: CR
authors.lastname: Richardson
authors.forename: Beverley B
authors.initials: BB
authors.lastname: Brown
authors.forename: Sharon
authors.initials: S
authors.lastname: Foley
authors.forename: Kathleen S
authors.initials: KS
authors.lastname: Dial
authors.forename: Julie C
authors.initials: JC
authors.lastname: Lowery
mesh_terms: D015992:Body Mass Index; D003376:Counseling / Q000592:standards*; D005240:Feasibility Studies; D005246:Feedback; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009747:Nutritional Physiological Phenomena; D016896:Treatment Outcome; D014584:User-Computer Interface; D015431:Weight Loss