The World Health Organization identified sedentary lifestyle as the 4th leading cause of death globally, impacting approximately 1.5 billion people and contributing to at least 3.2 million deaths annually. Walking is one of the easiest forms of physical activity, but the optimal number of steps needed for noticeable health benefits remain uncertain.
A recent meta-analysis by Banach et al., published in the “European Journal of Preventive Cardiology”, reported that an increase in daily steps by 1000 or 500 steps can drastically reduce the risk of both all-cause and cardiovascular (CV) mortality. The study further suggested that starting with even relatively modest daily step goal of 2,500 to 4,000 steps could yield noticeable health benefits.
This meta-analysis included 17 cohort studies (2,26,889 total participants; mean age: 64.4 ± 6.7 years; median follow-up: 7.1 years) and assessed the effects of daily step count on all-cause and CV mortality. In the included studies, the daily number of step counts was measured for at least 7 consecutive days using validated tools like pedometers and/or accelerometers. The outcome of the meta-analysis was to establish a dose-response relationship between step count/day and mortality, and to assess the impact of other factors such as age, gender, and climatic zones on the daily step count and mortality. For calculations, range of daily steps taken in individual studies were divided as quartiles and median of each quartile was determined.
The study results are summarized below:
- Increasing step count by 1000 steps daily was associated with significant reduction in the risk of all-cause mortality, while a daily increase of step count by 500 steps was linked with significant reduction in CV mortality risk (p <0.001; refer to graphic [A]).
- Quartiles with higher number of median steps/days demonstrated significant reduction in mortality compared to the reference daily step count in the lowest quartile (p <0.005; refer to graphic [B]).
- As the daily step count increased, reduction in mortality risk was noted (a significant non-linear inverse dose-response relationship [p <0.001] was observed between daily step count and risk of all-cause and CV mortality).
- No significant effect of place of walk and gender was observed on the outcomes.
- A daily count of 5500 steps reduced all-cause mortality risk across all climatic zones.
- Younger individuals (<60 years) showed greater mortality risk reduction than older adults (≥60 years) with increasing steps (p =0.009; refer to graphic [C]).
Clinical implications
- Increasing physical activity level by adding just 1000 or 500 steps to the daily step count can substantially lower the risk of overall mortality, including CV-related deaths, ultimately contributing to an extended lifespan.
- A minimum of 4000 steps/day can significantly reduce all-cause mortality risk.
- Benefits of walking on mortality risk reduction was more pronounced when incorporated as a daily regimen at a younger age compared to initiating it later in life.
(Reference: Banach M, Lewek J, Surma S, Penson PE, Sahebkar A, Martin SS, Bajraktari G, Henein MY, Reiner Ž, Bielecka-Dąbrowa A, Bytyçi I. The association between daily step count and all-cause and cardiovascular mortality: A meta-analysis. Eur J Prev Cardiol. 2023:zwad229. Doi: 10.1093/eurjpc/zwad229)