Cardiothoracic surgeon Dr. Kath Magialto checks machine in the emergency room as she dashes about the room wearing her pedometer during her step filled day, December 29, 2009, in Torrance, California.

If the journey toward fitness begins with a single step, make sure it's counted with a pedometer.

These little step-tracking gadgets now have a solid track record when it comes to motivating people to exercise. And their popularity is growing.

Inside this small-as-an-egg device are the keys to exercise success that have eluded far more complex and expensive fitness programs: accountability, goal-setting and being able to monitor progress. If the objective is to reach 10,000 steps in a day (the recommended amount), seeing a tally of 4,000 steps at 3 p.m. is a wake-up call to start walking.

"When we ask people to start an exercise program, it's important to have measurable, achievable goals, and adding this self-monitoring component is very critical," says Simon Marshall, associate professor of exercise and nutritional science at San Diego State University. "We don't know why exactly, but keeping a number, a prompt, in our consciousness on a regular basis is important, and that's why pedometers are superior to other methods. It's on you all the time."

The fact that nothing has to be written down — no fitness diary needs to be kept, no information must be logged on a computer — makes pedometers easy to use day after day in various settings, none of which has to be a gym.

Perhaps better yet, the average cost is around $20.

"People describe them as being like little personal trainers," says Catrine Tudor-Locke, associate professor and director of the Walking Behavior Laboratory at Pennington Biomedical Research Center in Baton Rouge, La. "They provide ready, real-time data so you can make decisions about how you're going to spend the rest of your day and make adjustments as needed."

Los Angeles-based personal trainer Harley Pasternak has been studying the health habits of various cultures for his latest book, "The 5-Factor World Diet." He says, "What I found was that in the 10 healthiest countries in the world, they all have different (dietary habits). But one thing they all share is that they all walk way more than we do in America. For those in these 10 countries, being fit and healthy is about having an active lifestyle, while here in America, being fit is about performing an exercise in a room designated for fitness."

Pedometers can create that lifestyle balance that many Americans otherwise would lack.

FITS ANY LIFESTYLE

At 12:30 on a recent afternoon, Dr. Kathy Magliato's pedometer already reads 19,000 steps for the day. "I'm a cardiothoracic surgeon who's also a busy mommy with two small kids, so I run around quite a bit," she says. She typically gets her steps in while doing rounds at St. John's Health Center in Santa Monica or Torrance Memorial Medical Center. On days when she's in surgery for 10 hours, she takes her children for a walk when she gets home.

Magliato clipped on her first pedometer six years ago after the birth of her first child. With 10 pounds to lose and no time to go to a gym, she had to do something to stay in shape — both for herself and as a role model for her patients, many of whom have heart disease. Through walking and watching her diet, she dropped the 10 pounds and realized that walking provided the activity she needed, which some fitness experts and researchers say is the key to true health.

"When my patients tell me they can't work out because they don't have time, I say, 'Look at my lifestyle.'"

Pedometers have even made their way into the White House. In October, Peter Orszag, director of the Office of Management and Budget, issued a pedometer challenge through the end of 2009 to all willing agency employees. In an office blog post, Orszag (a runner and marathoner) wrote: "This year, as part of their budget submissions, federal agencies have been asked to report on their efforts to improve the health and wellness of their employees. I want to make sure that the staff at OMB doesn't just talk the talk on wellness, but that we also walk the walk — literally."

With approximately 115 to 200 men and women taking part, weekly step averages went from 10,871 the first week (beginning Oct. 4) to 13,000 in early December. (Final tallies aren't yet available.)

Research confirms that monitoring daily steps helps people get the recommended amount of exercise, bolsters their cardiovascular system and often contributes to weight loss.

A 2007 study in the Journal of the American Medical Assn. analyzed data from 26 studies assessing pedometer use among adults and found the device to be linked with considerable increases in physical activity and decreases in blood pressure and body mass index. In a 2004 study in Medicine & Science in Sports & Exercise, 27 people were assigned to a pedometer-based exercise group with an emphasis on daily steps and 33 people to an exercise program emphasizing time spent exercising.

At the end of the study, the pedometer-based program proved to be more effective in increasing daily activity than the time-based program.

SET A GOAL

Clipping on a pedometer and counting steps — even brisk ones — isn't the end of the fitness story. "It's one thing to wear a pedometer, but it's another to have a goal in mind of how many steps you want to get," says Karen Croteau, a professor in the department of exercise, health and sport sciences at the University of Southern Maine. "These gadgets are effective when serving as a cue, but that has to be in conjunction with setting goals."

She suggests that new users monitor steps for a few days to find a daily average before upping the amount. Some fitness experts recommend adding 5 percent to 10 percent of the starting average per day, but Tudor-Locke believes that fitness levels and daily routines should be taken into consideration. "One person has to juggle child rearing while another has different lifestyle impediments," she says. "People should find out where they are and realize that more is better."

And while walking 10,000 steps a day is admirable, reaching that goal every day over a long period of time may cause a fitness plateau, in which cardio gains stop and weight sneaks back on. In that case, users must increase both steps and intensity.

(But keep in mind, walking shouldn't be the only exercise in the repertoire. Strength training for both the upper and lower body prevents muscle loss and helps stave off bone deterioration, both important as people age.)

Choosing a pedometer can be challenging, considering how many models are on the market. Some are equipped with accelerometers that record movement and intensity. Others tally weekly steps, have calorie counters and come with software to track progress. Some cellphones now come with a pedometer, but since the devices track steps by monitoring hip movement, they won't work if left on a table or in a purse on the floor.

Many exercise physiologists and trainers generally recommend starting with a basic model that just counts steps and costs about $20. To ensure accuracy, count out from 20 to 50 steps a few times, checking the pedometer. If the count is within a few steps, it should be adequate. You can always upgrade later to a model with more bells and whistles.

Says Marshall, "You're only limited by how creative you can be."