“The more steps you walk, the better the effects on your health, and every increase of steps by 500-1000 steps/day may be associated with significant mortality reductions,” first author Dr. Maciej Banach, deputy editor-in-chief of the European Society of Cardiology, said in an email.
Anything below 5,000 steps a day is considered a “sedentary lifestyle,” according to the study.
“We showed that every increase of steps by 1000 steps/day is associated with a 15 percent reduction in the risk of dying from any cause, and every increase by 500 steps/day is associated with a seven percent reduction in dying from cardiovascular disease,” added Banach, who is also an adjunct professor of cardiology at Johns Hopkins University School of Medicine in Baltimore, Maryland.
The fact that it takes fewer steps to reduce risk of cardiovascular disease is not surprising, said Dr. David Katz, a specialist in preventive and lifestyle medicine who was not involved in the study.
“Exercise directly conditions the cardiovascular system, whereas benefit to other systems or conditions is somewhat less direct,” said Katz, president and founder of the nonprofit True Health Initiative, a global coalition of experts dedicated to evidence-based lifestyle medicine.
The study’s methods were “robust and state of the art,” and support what doctors often tell their patients, Katz said. “First, any exercise is better than none — with significant cardiovascular and overall health benefit at quite modest levels,” he added. “And for the range of activity that pertains to the public at large — the more, the better!”
Large analysis of existing studies
The study, published Tuesday in the European Journal of Preventive Cardiology, analyzed data on nearly 227,000 people from 17 studies performed in Australia, Japan, Norway, Spain, the United Kingdom and the United States. “To our best knowledge it is the largest analysis (done) so far,” Banach said. The analysis was also able to examine “for the first time” whether taking up to 20,000 steps a day was associated with health benefits, he added.
All of the studies were observational and therefore could only show an association between the number of steps per day and health, not a direct cause and effect.
While approximately 4,000 steps a day was associated with a “significant” reduction in the risk of an early death, the biggest impact on risk occurred when people walked more than 7,000 steps a day, with the most benefit occurring at about 20,000 steps, the study found.
“However, I should emphasize that there were limited data available on step counts up to 20,000 a day, and so these results need to be confirmed in larger groups of people,” said senior study author Dr Ibadete Bytyçi, a preventive cardiologist at the University Clinical Centre of Kosovo, in Pristina, Kosovo, in a statement.
Health benefits were the same across all countries for both men and women, according to the study. While both older participants — defined as over age 60 — and younger people saw benefits, “the size of the reduction in risk of death was smaller (in older people) than that seen in people below 60 years,” Banach said.
Start early and keep it up
Adults 60 and older who walked between 6,000 and 10,000 steps a day saw a 42 percent reduction in risk of early death, while people under 60 who walked between 7,000 and 13,000 steps a day had a 49 percent reduction in risk, he said.
The difference is likely explained by the formula, “the earlier, the better,” Banach said. Starting any health intervention early, whether it be regular physical activity at recommended levels, a healthy diet or other positive lifestyle changes, will have the most impact on cholesterol, blood pressure, fasting blood glucose, and other triggers for disease, he added.
“If you will be regular and consistent with the physical activity — we call it adherent to physical activity — you can always expect significant health benefit and live longer,” Banach said.
What if you can’t manage the number of steps the study found to be most beneficial? Don’t stress about it, said Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver, Colorado.
“I think the study simply shows exercise is good, being non-sedentary is good, and the more exercise you can get the better,” said Freeman, who was not involved in the research.
“It’s unlikely there’s a magic threshold in your body in which a little timer pops up and says ‘That’s good. You’re good to go,” if you cross 5,000, 10,000, or 20,000 steps in a day,” he said.
“What I tell people who are just starting out and they can’t get a lot of steps in is, ‘Don’t lose hope. Every bit of exercise counts. Keep doing what you’re doing until you get breathless for at least 30 minutes a day.’”
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