Association between the number of steps performed during work and metabolic syndrome indicators in São Paulo city military police officers: The health promotion of Military Police (HPMP) study




Body composition; Occupational medicine; Metabolic diseases; Cardiovascular diseases; Physical activity level.


We evaluated the working number steps (STEPS) of 25 military police officers (MPOs: day shift n = 14 and night shift n = 11) from the Military Police of São Paulo State (PMESP) while patrolling São Paulo city center and its association with metabolic syndrome (MetS) indicators. The participants' body composition and anthropometric parameters: body mass index (BMI), fat-free mass (FFM), skeletal muscle mass (SMM) and clinical and laboratory data: systolic (SBP) and diastolic (DBP) blood pressure, and fasting plasma levels of glucose, glycated hemoglobin A1c (HbA1c), insulin, HDL-cholesterol, triacylglycerol (TG), and C-reactive protein (CRP) were also measured. According to the number of steps taken during the daily 12 h working period, the MPOs were divided into three groups: 600-2,000, 2,001-8,000, and >8,000 steps. On average, each participant took 5169 ± 614 steps per 12 h shift. While MPOs from the night shift walked 25% more than the day shift (6188±1069 vs. 4367±664), this difference was not statistically significant. Notably, the BMI, FFM (13.4%), SMM (14.5%), plasma HDL-cholesterol levels (32.2%), and DBP (19.1%) were significantly higher in group 1 compared to the other two groups. Furthermore, reduced physical activity, age, BMI, and tenure at PMESP were associated with increased MetS indicators. Overall, MPOs performing less than 2,000 steps per shift presented marked changes in body composition and plasma measurements and a higher MetS prevalence (64%) than those who were more physically active.

Author Biographies

Leandro Porto dos Santos, Cruzeiro do Sul University

*These authors equally contributed to this study.

Diego Ribeiro de Souza, Military Police of São Paulo State

*These authors equally contributed to this study.


Alberti, K. G., Eckel, R. H., Grundy, S. M., Zimmet, P. Z., Cleeman, J. I., & Donato, K. A. (2009). Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation, 120(16), 1640-1645.

Association, A. D. (2018). 2. Classification and diagnosis of diabetes: standards of medical care in diabetes—2018. Diabetes care, 41(Supplement 1), S13-S27.

Association, A. D. (2020). 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care, 43(Suppl 1), S14.

Baughman, P., Andrew, M. E., Burchfiel, C. M., Fekedulegn, D., Hartley, T. A., Violanti, J. M., & Miller, D. B. (2016). High‐protein meal challenge reveals the association between the salivary cortisol response and metabolic syndrome in police officers. American Journal of Human Biology, 28(1), 138-144.

Bays, H. E., Toth, P. P., Kris-Etherton, P. M., Abate, N., Aronne, L. J., Brown, W. V., & La Forge, R. (2013). Obesity, adiposity, and dyslipidemia: a consensus statement from the National Lipid Association. Journal of clinical lipidology, 7(4), 304-383.

Bazotte, R. B., Silva, L. G., & Schiavon, F. P. (2014). Insulin resistance in the liver: deficiency or excess of insulin? Cell Cycle, 13(16), 2494-2500.

Bener, A., Yousafzai, M. T., Darwish, S., Al-Hamaq, A. O., Nasralla, E. A., & Abdul-Ghani, M. (2013). Obesity index that better predict metabolic syndrome: body mass index, waist circumference, waist hip ratio, or waist height ratio. Journal of obesity, 2013.

Bosy-Westphal, A., Schautz, B., Later, W., Kehayias, J., Gallagher, D., & Müller, M. (2013). What makes a BIA equation unique? Validity of eight-electrode multifrequency BIA to estimate body composition in a healthy adult population. European journal of clinical nutrition, 67(1), S14-S21.

Bull, F. C., Al-Ansari, S. S., Biddle, S., Borodulin, K., Buman, M. P., Cardon, G., & Chou, R. (2020). World Health Organization 2020 guidelines on physical activity and sedentary behaviour. British journal of sports medicine, 54(24), 1451-1462.

Celis-Morales, C. A., Perez-Bravo, F., Ibañez, L., Salas, C., Bailey, M. E., & Gill, J. M. (2012). Objective vs. self-reported physical activity and sedentary time: effects of measurement method on relationships with risk biomarkers. PloS one, 7(5), e36345.

Chang, J.-H., Huang, P.-T., Lin, Y.-K., Lin, C.-E., Lin, C.-M., Shieh, Y.-H., & Lin, Y.-C. (2015). Association between sleep duration and sleep quality, and metabolic syndrome in Taiwanese police officers. International journal of occupational medicine and environmental health, 28(6), 1011.

Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults--The Evidence Report. National Institutes of Health. (1998). Obesity research, 6 Suppl 2, 51S–209S.”

De Onis, M., & Habicht, J.-P. (1996). Anthropometric reference data for international use: recommendations from a World Health Organization Expert Committee. The American journal of clinical nutrition, 64(4), 650-658.

de Souza, D. R., da Silva Junior, E. P., de Moura, J. R., Junior, J. R. L., Pires, A. C. L., Curi, R., & Pithon-Curi, T. C. (2018). Efficacy of a Health Promotion Guidance Program Applied to the Police of São Paulo City. Journal of Archives in Military Medicine, 6(4).

Ekblom-Bak, E., Halldin, M., Vikström, M., Stenling, A., Gigante, B., de Faire, U., & Hellénius, M.-L. (2021). Physical activity attenuates cardiovascular risk and mortality in men and women with and without the metabolic syndrome–a 20-year follow-up of a population-based cohort of 60-year-olds. European journal of preventive cardiology, 28(12), 1376-1385.

Esposito, K., Chiodini, P., Colao, A., Lenzi, A., & Giugliano, D. (2012). Metabolic syndrome and risk of cancer: a systematic review and meta-analysis. Diabetes care, 35(11), 2402-2411.

Faludi, A. A., Izar, M. C. O., Saraiva, J. F. K., Chacra, A. P. M., Bianco, H. T., Afiune, A. N., & Salgado, W. F. (2017). [Not Available]. Arq Bras Cardiol, 109(2 Supl 1), 1-76. (Atualização da Diretriz Brasileira de Dislipidemias e Prevenção da Aterosclerose – 2017.)

Filho, R. T. B., & D’Oliveira Jr, A. (2014). The prevalence of metabolic syndrome among soldiers of the military police of Bahia state, Brazil. American Journal of Men's Health, 8(4), 310-315.

Friedenreich, C. M., Neilson, H. K., O’Reilly, R., Duha, A., Yasui, Y., Morielli, A. R., & Courneya, K. S. (2015). Effects of a high vs moderate volume of aerobic exercise on adiposity outcomes in postmenopausal women: a randomized clinical trial. JAMA oncology, 1(6), 766-776.

Garbarino, S., & Magnavita, N. (2015). Work Stress and Metabolic Syndrome in Police Officers. A Prospective Study. PLoS One, 10(12), e0144318.

Gill, J. M., & Cooper, A. R. (2008). Physical activity and prevention of type 2 diabetes mellitus. Sports Medicine, 38(10), 807-824.

Green, A. N., McGrath, R., Martinez, V., Taylor, K., Paul, D. R., & Vella, C. A. (2014). Associations of objectively measured sedentary behavior, light activity, and markers of cardiometabolic health in young women. European journal of applied physiology, 114(5), 907-919.

Grundy, S. M., Brewer Jr, H. B., Cleeman, J. I., Smith Jr, S. C., & Lenfant, C. (2004). Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation, 109(3), 433-438.

Hoffmann, T. C., Maher, C. G., Briffa, T., Sherrington, C., Bennell, K., Alison, J., & Glasziou, P. P. (2016). Prescribing exercise interventions for patients with chronic conditions. Can Med Assoc Jounal, 188(7), 510-518.

Ismail, I., Keating, S., Baker, M., & Johnson, N. (2012). A systematic review and meta‐analysis of the effect of aerobic vs. resistance exercise training on visceral fat. Obesity reviews, 13(1), 68-91.

JI, A. R. (2019). Sedentary lifestyle a disease from xxi century. Clinica e investigacion en arteriosclerosis: publicacion oficial de la Sociedad Espanola de Arteriosclerosis, 31(5), 233-240.

Kraus, W. E., Janz, K. F., Powell, K. E., Campbell, W. W., Jakicic, J. M., Troiano, R. P., & Committee, P. A. G. A. (2019). Daily step counts for measuring physical activity exposure and its relation to health. Medicine and science in sports and exercise, 51(6), 1206.

Krumm, E. M., Dessieux, O. L., Andrews, P., & Thompson, D. L. (2006). The relationship between daily steps and body composition in postmenopausal women. Journal of women's health, 15(2), 202-210.

Lavie, C. J., Ozemek, C., Carbone, S., Katzmarzyk, P. T., & Blair, S. N. (2019). Sedentary Behavior, Exercise, and Cardiovascular Health. Circ Res, 124(5), 799-815.

Lee, S., & Kim, Y. (2013). Effects of exercise alone on insulin sensitivity and glucose tolerance in obese youth. Diabetes & metabolism journal, 37(4), 225-232.

Leiva, A. M., Martínez, M. A., Cristi-Montero, C., Salas, C., Ramírez-Campillo, R., Aguilar-Farías, N., & Celis-Morales, C. (2017). Sedentary lifestyle is associated with metabolic and cardiovascular risk factors independent of physical activity. Revista médica de Chile, 145(4), 458-467.

Madjd, A., Taylor, M. A., Delavari, A., Malekzadeh, R., Macdonald, I. A., & Farshchi, H. R. (2019). Effect of a Long Bout Versus Short Bouts of Walking on Weight Loss During a Weight‐Loss Diet: A Randomized Trial. Obesity, 27(4), 551-558.

Malachias, M. V. B., Bortolotto, L. A., Drager, L. F., Borelli, F. A. O., Lotaif, L. A. D., & Martins, L. C. (2016). 7th Brazilian Guideline of Arterial Hypertension: Chapter 12 - Secondary Arterial Hypertension. Arq Bras Cardiol, 107(3 Suppl 3), 67-74. (7ª Diretriz Brasileira de Hipertensão Arterial: Capítulo 12 - Hipertensão Arterial Secundária.)

Matthews, D. R., Hosker, J. P., Rudenski, A. S., Naylor, B. A., Treacher, D. F., & Turner, R. C. (1985). Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia, 28(7), 412-419.

McPhee, J. S., French, D. P., Jackson, D., Nazroo, J., Pendleton, N., & Degens, H. (2016). Physical activity in older age: perspectives for healthy ageing and frailty. Biogerontology, 17(3), 567-580.

Merino, P. S. (2010). Mortalidade em efetivos da polícia militar do Estado de São Paulo. Universidade Federal de São Paulo.

Murtagh, E. M., Murphy, M. H., & Boone-Heinonen, J. (2010). Walking–the first steps in cardiovascular disease prevention. Current opinion in cardiology, 25(5), 490.

Myers, J., Kokkinos, P., & Nyelin, E. (2019). Physical Activity, Cardiorespiratory Fitness, and the Metabolic Syndrome. Nutrients, 11(7).

Neeland, I., Ross, R., Després, J., Matsuzawa, Y., Yamashita, S., Shai, I., . . . Arsenault, B. (2019). International Atherosclerosis Society; International Chair on Cardiometabolic Risk Working Group on Visceral Obesity. Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: a position statement. Lancet Diabetes Endocrinol, 7(9), 715-725.

Neeland, I. J., Singh, S., McGuire, D. K., Vega, G. L., Roddy, T., Reilly, D. F., & Scherer, P. E. (2018). Relation of plasma ceramides to visceral adiposity, insulin resistance and the development of type 2 diabetes mellitus: the Dallas Heart Study. Diabetologia, 61(12), 2570-2579.

Paterson, D. H., & Warburton, D. E. (2010). Physical activity and functional limitations in older adults: a systematic review related to Canada's Physical Activity Guidelines. International Journal of Behavioral Nutrition and Physical Activity, 7(1), 1-22.

Payab, M., Hasani-Ranjbar, S., Merati, Y., Esteghamati, A., Qorbani, M., Hematabadi, M., & Shirzad, N. (2017). The prevalence of metabolic syndrome and different obesity phenotype in Iranian male military personnel. American journal of men's health, 11(2), 404-413.

Penedo, F. J., & Dahn, J. R. (2005). Exercise and well-being: a review of mental and physical health benefits associated with physical activity. Current opinion in psychiatry, 18(2), 189-193.

Roberts, W. L., Moulton, L., Law, T. C., Farrow, G., Cooper-Anderson, M., Savory, J., & Rifai, N. (2001). Evaluation of nine automated high-sensitivity C-reactive protein methods: implications for clinical and epidemiological applications. Part 2. Clinical chemistry, 47(3), 418-425.

Schneider, P. L., Crouter, S. E., Lukajic, O., & Bassett Jr, D. R. (2003). Accuracy and reliability of 10 pedometers for measuring steps over a 400-m walk. Medicine and science in sports and exercise, 35(10), 1779-1784.

Souza, D. R. d., Silva, E. N. d., Santos, L. P. d., Oliveira, L. C. d. S. d., Augusto, D. T., Silva, E. B. d., & Pithon-Curi, T. C. (2021). Prevalence of Metabolic Syndrome in Military Police Officers of São Paulo City: The Health Promotion in Military Police (HPMP) Study. Research, Society and Development, 10(14), e61101421142.

Sposito, A. C., Caramelli, B., Fonseca, F. A., Bertolami, M. C., Afiune Neto, A., Souza, A. D., & Loures-Vale, A. A. (2007). IV Diretriz brasileira sobre dislipidemias e prevenção da aterosclerose: Departamento de Aterosclerose da Sociedade Brasileira de Cardiologia. Arquivos brasileiros de cardiologia, 88, 2-19.

Tharkar, S., Kumpatla, S., Muthukumaran, P., & Viswanathan, V. (2008). High prevalence of metabolic syndrome and cardiovascular risk among police personnel compared to general population in India. J Assoc Physicians India, 56, 845-849.

Thornton, J. S., Frémont, P., Khan, K., Poirier, P., Fowles, J., Wells, G. D., & Frankovich, R. J. (2016). Physical activity prescription: a critical opportunity to address a modifiable risk factor for the prevention and management of chronic disease: a position statement by the Canadian Academy of Sport and Exercise Medicine. British journal of sports medicine, 50(18), 1109-1114.

Tudor-Locke, C., Craig, C. L., Brown, W. J., Clemes, S. A., De Cocker, K., Giles-Corti, B., & Mutrie, N. (2011). How many steps/day are enough? For adults. International Journal of Behavioral Nutrition and Physical Activity, 8(1), 1-17.

Tudor-Locke, C., Johnson, W. D., & Katzmarzyk, P. T. (2009). Accelerometer-determined steps per day in US adults. Medicine and science in sports and exercise, 41(7), 1384-1391.

Vancini, R. L., de Lira, C. A., Anceschi, S. A., Rosa, A. V., Lima-Leopoldo, A. P., Leopoldo, A. S., & Rosemann, T. (2018). Anxiety, depression symptoms, and physical activity levels of eutrophic and excess-weight Brazilian elite police officers: a preliminary study. Psychology research and behavior management, 11, 589.

Violanti, J. M., Burchfiel, C. M., Hartley, T. A., Mnatsakanova, A., Fekedulegn, D., Andrew, M. E., & Vila, B. J. (2009). Atypical work hours and metabolic syndrome among police officers. Archives of environmental & occupational health, 64(3), 194-201.

Vissers, D., Hens, W., Taeymans, J., Baeyens, J.-P., Poortmans, J., & Van Gaal, L. (2013). The effect of exercise on visceral adipose tissue in overweight adults: a systematic review and meta-analysis. PloS one, 8(2), e56415.

Warburton, D. E., & Bredin, S. S. (2016). Reflections on physical activity and health: what should we recommend? Canadian Journal of Cardiology, 32(4), 495-504.

Warburton, D. E., Nicol, C. W., & Bredin, S. S. (2006). Health benefits of physical activity: the evidence. Can Med Assoc Jounal, 174(6), 801-809.

Xavier, H., Izar, M., Neto, J. F., Assad, M., Rocha, V., Sposito, A., & Bertolami, M. (2013). V Brazilian guidelines on dyslipidemias and prevention of atherosclerosis. Arquivos brasileiros de cardiologia, 101(4 Suppl 1), 1-20.




How to Cite

SANTOS, L. P. dos .; SOUZA, D. R. de .; GORJAO, R. .; LEVADA-PIRES, A. C. .; HATANAKA, E. .; CURY-BOAVENTURA, M. F. .; RUSSO JUNIOR, D. V. .; BACCA, O. .; SILVA, E. B. da .; ZAMBONATTO, R. F. .; MASI, L. N. .; BAZOTTE, R. B. .; CURI, R.; PITHON-CURI, T. C. .; HIRABARA, S. M. . Association between the number of steps performed during work and metabolic syndrome indicators in São Paulo city military police officers: The health promotion of Military Police (HPMP) study. Research, Society and Development, [S. l.], v. 11, n. 2, p. e13511225376, 2022. DOI: 10.33448/rsd-v11i2.25376. Disponível em: Acesso em: 17 jun. 2024.



Health Sciences