title: Relationships between a walk test, body size and metabolic risk among a New Zealand Māori community.
abstract: OBJECTIVE
  Programmes to prevent or delay chronic disease incorporate promotion of physical activity, particularly walking. The objective of this study was to test the associations of the ability to walk quickly with measures of adiposity and metabolic risk including dysglycaemia.
  
  
  METHODS
  Participants (3209), without known diabetes, in a lifestyle trial undertook a 4-minute walk test (4MWT) following measurements of fasting lipids, 75 g oral glucose tolerance test, anthropometry and blood pressure. Lower socio-economic status was defined by possession of a 'community services card' (CSC). Dysglycaemia (diabetes, impaired glucose tolerance and impaired fasting glucose) and metabolic syndrome (MS) were defined by WHO and ATPIII criteria, respectively.
  
  
  RESULTS
  Controlling for age, length of the walk-course and height, distance walked during the 4MWT decreased linearly (p < 0.001) with increasing waist, body mass index, %fat mass and MS risk. On average those with dysglycaemia walked 15.2 (95% CI 9.3, 20.8) m less than 'normal' participants independent of gender. In the best-fit regression model, distance walked was associated with reduced distances walked 1.3 (1.2, 1.5) m/year of age, 0.9 (0.8, 1.1) m/kg fat, 15.7 (11.2, 19.5) m with a CSC and 8.0 (5.8,10.2) m if currently smoking. Each additional MS factor was associated with a reduction of the distance walked by 6.6 (4.6, 8.6) m.
  
  
  CONCLUSIONS
  Increasing numbers of MS components are associated with slower walking. The 4MWT is an easy assessment of functional limitation, which may have use in guiding intervention.
authors.affiliation: Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand. elaine.rush@aut.ac.nz
authors.forename: Elaine C
authors.initials: EC
authors.lastname: Rush
authors.forename: N
authors.initials: N
authors.lastname: Crook
authors.forename: D
authors.initials: D
authors.lastname: Simmons
mesh_terms: D050154:Adiposity; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D049628:Body Size; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology*; D008875:Middle Aged; D009520:New Zealand; D012307:Risk Factors; D016138:Walking