The joint association of health-enhancing walking and healthful diet with central obesity: a longitudinal repeated-measures study.

Abstract

Overweight is a global health crisis linked to chronic diseases. Traditional indicators like BMI have limitations, whereas novel central obesity indices are superior for assessing obesity-related health risks. We aim to explore the joint association of health-enhancing walking and healthful diet with central obesity. This study utilized data from the 100-Day Walking Program in Bozhou City (2022-2024). Daily step counts were tracked using dedicated pedometers. Central obesity indices, including the waist-to-weight index (WWI), conicity index (C-Index), and body shape index (ABSI), along with body composition parameters, were measured using a body composition analyzer. Linear mixed-effects models and generalized estimating equations were employed to assess the associations of daily steps with the obesity indices and weight loss success, respectively. Among 3 503 participants, the median average daily step count was 12 675. Each 1000-step increment was associated with reductions of 0.014 in WWI, 0.002 in C-Index, and 0.001 in ABSI. Exposure-response curves demonstrated a general decline in these indices with increasing steps. These inverse associations were significantly more pronounced in participants with higher dietary quality scores. In the joint analysis, participants with both higher step counts and higher dietary quality exhibited significantly lower central obesity indices than the reference group with low levels of both. Moreover, each 1000-step increase was associated with a 4% higher probability of successful short-term weight loss. Increasing daily steps is associated with improved central obesity indices and short-term weight loss success, particularly among participants with higher dietary quality.