Stair climbing for public health

Prolonged sitting is associated with increased risk of obesity, type 2 diabetes and cardiovascular diseases. This thesis explored the effectiveness of point-of-choice prompt among university students to promote stair usage and reduce the use of the lifts and consequently their cost. This thesis also assessed on the feasibility of the employees and potential of stair climbing activity to be incorporated at the workplace. The main aims were to increase stair use and reduce prolonged sitting at work. The first study displayed posters with message based on the potential calorific expenditure from a single total ascent for four weeks at student’s accommodation. Results showed no significant difference in electricity consumption during intervention for both terms (spring and autumn). Point-of-choice prompt displaying weight loss over a year with regular stair climbing based on the height of the building clearly did not promote stair usage among the students. Thus, different type of messages should be used in the future to test the interest of this target group towards stair use. The height of the building should also be considered where as higher buildings are recommended since more energy is used for the lift to reach the topmost level of the building and could generate significant difference before and after the intervention. Apart from that, this study did not measure the number of students who climbed the stairs during baseline and intervention periods as this could actually show individual response towards the point-of-choice prompt and stair use. An inconspicuous observer or a video recorder should be placed nearby to the stairwell to record the use of the stairs either by ascent or descent and to code the students by gender as well as weight status (normal weight, overweight, or obese). Second study was a feasibility study assessing on the employees’ feasibility of integrating stair climbing activity as an interruption to sitting throughout working hours, and determining the effects of intermittent stair climbing on glucose and lipid profiles. Participants were asked to climb four floors at one-hour intervals throughout eight hours working period. A pop up reminder was displayed on the participant’s office desktop. Blood samples were taken pre and post intervention. Findings revealed significant improvements in fasting blood glucose, low density lipoprotein cholesterol (LDL-C) and total cholesterol (TC)/high density lipoprotein cholesterol (HDL-C) ratio in the experimental group. There was no significant difference found for triglycerides (TG) and high density lipoprotein cholesterol. This study only managed to get eight participants for control group, quite a small number of sample size. This was due to the location of the study whereas only two buildings had four and more floors. Thus, it became a restriction to other employees from other buildings to join the study. If to be repeated in the near future, bigger sample size is required to increase the precision and power of the study and selection of the study site should also be taken into account. The positive health outcomes from regular stair climbing activity and its feasibility to be performed at work could be a stepping stone to the employers to promote healthier lifestyle among their sedentary employees. Stair climbing is a vigorous physical activity, and this study showed that integrating four floors of stair climbing eight times daily on weekdays could achieve recommended physical activity for adults. The final intervention was a laboratory based study testing on interrupted sitting at work with light intensity walking (3.0 km.hr-1) and vigorous intensity stair climbing (60 steps.min-1). Sitting was interrupted every 20 minutes in the seven-hour trial after the consumption of moderate fat meal. Significant improvements of triglycerides were observed after 2-hour and 5-hour tests for light intensity walking when compared to uninterrupted sitting. There was no significant difference found for triglycerides, glucose and non-esterified fatty acids (NEFA) for stair climbing in comparison with uninterrupted sitting. However, reduction in postprandial peak in plasma glucose and attenuation of the NEFA were observed. It was expected that the more intense the physical activity, the greater the effects, but the data showed otherwise. These findings could be due to the compliance of the participants towards preparing and consuming the meals the day before the testing. Participants were given the food diary to write down details of each recipe in terms of ingredients and how it was prepared to ensure the calorie intake remains the same prior to the three testing sessions. It is recommended in the future to provide the meals for the participants as their compliance could be compromised. Apart from that, participants were advised to continue with their normal routine during the six days wash-out period prior to the next testing session. Their adherence towards instruction to avoid performing any moderate and vigorous physical activities during this period could have been violated and might have affected the results. Thus, if similar study protocols are to be repeated in the future, it is recommended to send periodic reminder to the participants to maintain their customary physical activity and provide physical activity diary to monitor their daily activities. In conclusion, stair climbing can be prescribed to break prolonged sitting and reduce sedentary time hence improves employees’ health.