Summary: A new meta-analysis of 15 studies reveals the optimum number of steps people of different age ranges should take per day in order to maximize longevity.
A meta-analysis of 15 studies involving nearly 50,000 people from four continents offers new insights into identifying the amount of daily walking steps that will optimally improve adults’ health and longevity – and whether the number of steps is different for people of different ages.
The analysis represents an effort to develop an evidence-based public health message about the benefits of physical activity. The oft-repeated 10,000-steps-a-day mantra grew out of a decades-old marketing campaign for a Japanese pedometer, with no science to back up the impact on health.
Led by University of Massachusetts Amherst physical activity epidemiologist Amanda Paluch, an international group of scientists who formed the Steps for Health Collaborative found that taking more steps a day helps lower the risk of premature death. The findings are reported in a paper published March 2 in Lancet Public Health.
More specifically, for adults 60 and older, the risk of premature death leveled off at about 6,000-8,000 steps per day, meaning that more steps than that provided no additional benefit for longevity. Adults younger than 60 saw the risk of premature death stabilize at about 8,000-10,000 steps per day.
“So, what we saw was this incremental reduction in risk as steps increase, until it levels off,” Paluch says. “And the leveling occurred at different step values for older versus younger adults.”
Interestingly, the research found no definitive association with walking speed, beyond the total number of steps per day, Paluch notes. Getting in your steps – regardless of the pace at which you walked them – was the link to a lower risk of death.
The new research supports and expands findings from another study led by Paluch, published last September in JAMA Network Open, which found that walking at least 7,000 steps a day reduced middle-aged people’s risk of premature death.
The Physical Activity Guidelines for Americans, updated in 2018, recommends adults get at least 150 minutes of moderate-intensity aerobic physical activity each week. Paluch is among the researchers seeking to help establish the evidence base to guide recommendations for simple, accessible physical activity, such as walking.
“Steps are very simple to track, and there is a rapid growth of fitness tracking devices,” Paluch says. “It’s such a clear communication tool for public health messaging.”
The research group combined the evidence from 15 studies that investigated the effect of daily steps on all-cause mortality among adults age 18 and older. They grouped the nearly 50,000 participants into four comparative groups according to average steps per day. The lowest step group averaged 3,500 steps; the second, 5,800; the third, 7,800; and the fourth, 10,900 steps per day.
Among the three higher active groups who got more steps a day, there was a 40-53% lower risk of death, compared to the lowest quartile group who walked fewer steps, according to the meta-analysis.
“The major takeaway is there’s a lot of evidence suggesting that moving even a little more is beneficial, particularly for those who are doing very little activity,” Paluch says. “More steps per day are better for your health. And the benefit in terms of mortality risk levels off around 6,000 to 8,000 for older adults and 8,000 to 10,000 for younger adults.”
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Author: Patty Shillington Source: UMass Contact: Patty Shillington – UMass Image: The image is in the public domain
Daily steps and all-cause mortality: a meta-analysis of 15 international cohorts
Although 10 000 steps per day is widely promoted to have health benefits, there is little evidence to support this recommendation. We aimed to determine the association between number of steps per day and stepping rate with all-cause mortality.
In this meta-analysis, we identified studies investigating the effect of daily step count on all-cause mortality in adults (aged ≥18 years), via a previously published systematic review and expert knowledge of the field. We asked participating study investigators to process their participant-level data following a standardised protocol. The primary outcome was all-cause mortality collected from death certificates and country registries.
We analysed the dose–response association of steps per day and stepping rate with all-cause mortality. We did Cox proportional hazards regression analyses using study-specific quartiles of steps per day and calculated hazard ratios (HRs) with inverse-variance weighted random effects models.
We identified 15 studies, of which seven were published and eight were unpublished, with study start dates between 1999 and 2018. The total sample included 47 471 adults, among whom there were 3013 deaths (10·1 per 1000 participant-years) over a median follow-up of 7·1 years ([IQR 4·3–9·9]; total sum of follow-up across studies was 297 837 person-years).
Quartile median steps per day were 3553 for quartile 1, 5801 for quartile 2, 7842 for quartile 3, and 10 901 for quartile 4. Compared with the lowest quartile, the adjusted HR for all-cause mortality was 0·60 (95% CI 0·51–0·71) for quartile 2, 0·55 (0·49–0·62) for quartile 3, and 0·47 (0·39–0·57) for quartile 4. Restricted cubic splines showed progressively decreasing risk of mortality among adults aged 60 years and older with increasing number of steps per day until 6000–8000 steps per day and among adults younger than 60 years until 8000–10 000 steps per day.
Adjusting for number of steps per day, comparing quartile 1 with quartile 4, the association between higher stepping rates and mortality was attenuated but remained significant for a peak of 30 min (HR 0·67 [95% CI 0·56–0·83]) and a peak of 60 min (0·67 [0·50–0·90]), but not significant for time (min per day) spent walking at 40 steps per min or faster (1·12 [0·96–1·32]) and 100 steps per min or faster (0·86 [0·58–1·28]).
Taking more steps per day was associated with a progressively lower risk of all-cause mortality, up to a level that varied by age. The findings from this meta-analysis can be used to inform step guidelines for public health promotion of physical activity.