A meta-analysis of twelve studies offers insights into the ideal number of daily steps for health benefits.
Findings suggest that even approximately 2,500 steps per day can initiate positive effects, with benefits increasing at higher step counts. For the most significant decrease in all-cause mortality and cardiovascular risk, about 9,000 and 7,000 steps daily, respectively, are recommended.
Over recent years, research has sought to answer the question, How many steps per day are needed to achieve health benefits? A meta-analysis, evaluating data from twelve studies, offers what may be the clearest answer yet.
Findings reveal that health improvements begin with daily step counts between 2,500 and 2,700.
For optimal cardiovascular health, the recommended number is approximately 7,000 steps per day (precisely 7,126), while the most significant reduction in mortality risk is associated with about 9,000 daily steps (8,763 steps).
For those achieving 2,500 steps daily, an 8% reduction in all-cause mortality risk was noted, while 2,700 steps showed an 11% decrease in cardiovascular events. With a daily count of 9,000 steps, early mortality risk drops by 60%, and 7,000 steps reduce cardiovascular disease risk by 51%.
The popularized goal of 10,000 daily steps has been largely discredited, as it originated from a 1964 pedometer advertisement without scientific backing.
Further health benefits were observed with intermediate and brisk walking speeds, complementing the benefits linked to step count. This meta-analysis drew from health records of 111,309 individuals who wore accelerometers or fitness trackers.
Health benefits are achievable with fewer than 10,000 steps.
According to senior investigator Dr. Thijs M.H. Eijsvogels, “This is the first study to objectively quantify the minimal and optimal stepping volume for health outcomes.” Dr. Eijsvogels also noted, “These step targets were independent of sex, device type, or wearable location, reinforcing the robustness of our findings and the possibility to add these step targets to future physical activity guidelines.”
“This study reiterates what we have seen in our previous work. Move more and sit less. It is not an all-or-nothing situation.”
Dr. Amanda Paluch, assistant professor of kinesiology at the University of Massachusetts and a member of the Steps for Health Collaborative,
Dr. Paluch suggested that, regardless of current step counts, setting incremental goals to gradually increase steps can support improved health outcomes.
Further support for incremental steps was echoed by Dr. Cheng-Han Chen, cardiologist and medical director of the Structural Heart Program at Saddleback Medical Center, who expressed approval for the clear step targets the study provides.
Commenting on the flexibility of step targets, Dr. Paluch clarified that reaching 10,000 steps or more is not problematic.
“These results are not an indication that taking more than 10,000 steps may be harmful. There just appears to be diminishing returns at these higher levels.”
Dr. Paluch
“In fact, a decrease in mortality continues to be seen at up to 8,763 steps, and a reduced cardiovascular risk/incidence is realized up to 7,126 steps.”
Dr. Jayne Morgan, cardiologist and clinical director of the Covid Task Force at Piedmont Healthcare Corporation in Atlanta, GA,
Dr. Morgan further noted that these findings suggest almost 1.5 miles fewer than the widely promoted 10,000-step recommendation.
Does walking pace influence health outcomes?
Dr. Amanda Paluch explains,
“In observational studies like this one, it is difficult to tease out the association since walking volume and pace are closely related — those who step faster tend to also have more daily steps.”
Dr. Amanda Paluch
She adds that limited data on stepping pace and health benefits restricts strong conclusions on whether a faster pace is essential or if simply achieving daily steps is sufficient.
“A higher pace is more helpful than a slower pace.”
Dr. Cheng-Han Chen
Dr. Jayne Morgan highlights the accessibility of walking, emphasizing,
“This is huge, as walking is accessible to most, and although faster paces were associated with the highest reduction in heart disease, lower cadences (slower pace of walking) also showed a decrease in heart disease risk.”
Dr. Jayne Morgan
Should older adults aim for the same step count?
Dr. Jayne Morgan emphasizes that the study’s:
“Big takeaway is for our aging population. Walking, literally any amount daily, helps toward the goal of living a healthy lifestyle and reducing cardiovascular risk.”
Dr. Jayne Morgan
Dr. Cheng-Han Chen observes that aiming for 10,000 steps may seem daunting for many, explaining,
“It tells us that we don’t need to target 10,000 to get most of the benefit because sometimes it can be discouraging for people saying, ‘oh boy, that sounds like a really high number.’”
Dr. Cheng-Han Chen
Dr. Morgan adds that for older adults, a more manageable goal of around 2,500 steps—a roughly 1.25-mile walk—is often more attainable than the five-mile, 10,000-step target.
Dr. Chen finds the study’s results encouraging for older patients, as even lower step counts contribute to improved health outcomes. Concerned about the frailty that often accompanies aging, Dr. Chen focuses on small, realistic goals, stating,
“I’m not trying to get them from 5,000 to 10,000. I’m just trying to get them from 0 to 2,000 to 3,000. Maybe 10 minutes a day, and just turn it into a habit.
Dr. Cheng-Han Chen
Dr. Thijs M.H. Eijsvogels concludes,
“We found that every step counts. Small increases in daily steps can yield substantial health benefits, so adding 1,000 steps to daily routines (~10 mins of walking) is worthwhile to consider for everyone.”
Dr. Thijs M.H. Eijsvogels
https://doi.org/10.1016/j.jacc.2023.07.029
Abstract
Background
The minimal and optimal daily step counts for health improvements remain unclear.
Objectives
A meta-analysis was performed to quantify dose-response associations of objectively measured step count metrics in the general population.
Methods
Electronic databases were searched from inception to October 2022. Primary outcomes included all-cause mortality and incident cardiovascular disease (CVD). Study results were analyzed using generalized least squares and random-effects models.
Results
In total, 111,309 individuals from 12 studies were included. Significant risk reductions were observed at 2,517 steps/d for all-cause mortality (adjusted HR [aHR]: 0.92; 95% CI: 0.84-0.999) and 2,735 steps/d for incident CVD (aHR: 0.89; 95% CI: 0.79-0.999) compared with 2,000 steps/d (reference). Additional steps resulted in nonlinear risk reductions of all-cause mortality and incident CVD with an optimal dose at 8,763 (aHR: 0.40; 95% CI: 0.38-0.43) and 7,126 steps/d (aHR: 0.49; 95% CI: 0.45-0.55), respectively. Increments from a low to an intermediate or a high cadence were independently associated with risk reductions of all-cause mortality. Sex did not influence the dose-response associations, but after stratification for assessment device and wear location, pronounced risk reductions were observed for hip-worn accelerometers compared with pedometers and wrist-worn accelerometers.
Conclusions
As few as about 2,600 and about 2,800 steps/d yield significant mortality and CVD benefits, with progressive risk reductions up to about 8,800 and about 7,200 steps/d, respectively. Additional mortality benefits were found at a moderate to high vs a low step cadence. These findings can extend contemporary physical activity prescriptions given the easy-to-understand concept of step count. (Dose-Response Relationship Between Daily Step Count and Health Outcomes: A Systematic Review and Meta-Analyses; CRD42021244747)
