Researchers from Italy and Lebanon conducted a systematic review and meta-analysis of 18 randomized controlled trials, with 14 studies involving 3,758 individuals included in the final analysis. The study, published in the International Journal of Environmental Research and Public Health, was led by Professor Marwan El Ghoch from the University of Modena and Reggio Emilia in Italy. Participants had an average age of 53 and an average BMI of 31, and came from countries including the UK, US, Australia and Japan.
The studies compared 1,987 people in lifestyle modification programmes with 1,771 people who were dieting alone or receiving no treatment. The lifestyle programmes included dietary advice alongside recommendations to walk more and track daily step counts. Daily steps were measured at the start, after the weight-loss phase (average 7.9 months), and after the maintenance phase (average 10.3 months). At the start, both groups had similar step counts: 7,280 in the lifestyle group and 7,180 in the comparison group. The lifestyle modification group increased daily steps to an average of 8,454 by the end of the weight-loss phase, while the control group did not significantly increase activity levels or lose weight. The lifestyle group maintained an average weight loss of 3.28% (around 3 kg or 6.6 lbs) at the end of trials.
According to researchers, there was a clear link between increasing step count and preventing weight regain. During the weight loss phase, reduced calorie intake seemed to play the biggest role. Professor El Ghoch noted that around 80% of people with overweight or obesity who initially lose weight tend to regain some or all of it within three to five years. "The identification of a strategy that would solve this problem and help people maintain their new weight would be of huge clinical value," he said. He added that participants should be encouraged to increase their step count to approximately 8,500 steps per day.
The study did not specify the exact dietary advice given, nor did it detail how weight regain was defined. It also did not account for other forms of physical activity beyond walking, and it remains unclear whether outcomes varied by age, gender, or baseline BMI.