medwireNews: People can gain significant mortality and cardiovascular benefits by taking as few as 2600–2800 steps a day, suggests a meta-analysis published in the Journal of the American College of Cardiology.
The researchers note that “such activity levels are feasible for the majority of the general population, including older adults and individuals with chronic diseases.”
Further benefit was achieved with higher step counts, they add, but there were only “minimally improved” risk reductions for all-cause mortality and incident cardiovascular disease (CVD) beyond 8800 and 7200 steps/d, respectively.
“This plateau suggests that most benefits were achieved at step counts <10,000 steps/d, which aligns with observations from recent other meta-analyses,” say Thijs Eijsvogels (Radboud University Medical Center, Nijmegen, the Netherlands), and colleagues.
The investigators conducted a comprehensive literature search up to October 2022, identifying 12 studies involving 1,11,309 adults (60.8% women) aged an average 62.5 years, who did not have CVD at baseline. Eleven studies assessed the association between step count and all-cause mortality, four between step count and incident CVD, and four between step cadence and all-cause mortality. In all studies, precise step-counting tools were used, such as accelerometers or pedometers.
Over a median follow-up of 77.8 months, 4.4% of participants died, while 1.4% developed CVD during a follow-up of 72.9 months.
The minimum daily step count needed to gain a reduction in all-cause mortality was 2517 steps, which was associated with a significant 8% reduced risk compared with a reference of 2000 steps/d , after taking into account factors such as body mass index, age, sex, smoking status, and relevant comorbidities. For incident CVD, a significant 11% risk reduction was seen at a minimum daily count of 2735 versus 2000 steps.
“Increases of 1,000 steps/d were associated with additional health benefits, especially among those with a low number of baseline steps, highlighting that every step counts,” the team points out.
The risk for both all-cause mortality and CVD steadily decreased up to a maximum risk reduction of 60% and 51% at daily step counts of 8763 and 7126, respectively.
The study authors note that step cadence was also linked to a reduced risk for mortality. People with an intermediate (63 steps/min) or high (88 steps/min) step cadence were 33% and 38% less likely to die over follow-up than those with a low cadence (29 steps/min). The reduction in risk was attenuated slightly after adjusting for step count but still remained significant.
They say: “These findings underline that both volume (steps per day) and intensity (cadence, or steps per minute) are independently associated with health and that their risk reductions are additive.”
Discussing the findings in a related editorial, Carl Lavie (The University of Queensland School of Medicine, New Orleans, Louisiana, USA) and colleagues say that the current study delivers “a clear, comforting, and uplifting message" on the benefits of physical activity, “with maximal benefits well below the ‘magic’ number of 10,000 steps/d,” which was cited by a pedometer manufacturer rather than based on clinical evidence.
The editorialists conclude: “The lower number of steps per day needed to reduce mortality and CVD should provide comfort and encouragement to the public, as well as to clinicians.”
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