Steps per day and all-cause mortality: How much is enough? Original paper

In this meta-analysis, a daily step count of 7,000–9,000 was associated with the lowest risk of all-cause mortality, and the number of steps that maximally reduced all-cause mortality was different in younger and older adults but was no different between male and female participants.

This Study Summary was published on August 23, 2022.

Background

Regular physical activity reduces the risk of most major diseases including cancer, diabetes, and cardiovascular disease.[1] However, the precise amount of physical activity that maximally reduces one’s risk of death and disease remains a topic of debate. Furthermore, the benefits of physical activity on mortality risk may be subject to diminishing returns — meaning that increasing levels of activity beyond a certain amount may not further reduce one’s risk of death.

To better inform public health recommendations about the optimal levels of physical activity, an analysis of the relationship between daily step counts and all-cause mortality was needed. Does taking more steps per day lead to a lower risk of death?

The study

This dose-response meta-analysis of 15 prospective cohort studies determined the age-specific and sex-specific associations between steps per day and all-cause mortality in a total of 47,471 participants (average age of 65; 32% men, 68% women; 70% white). The studies were conducted in Asia, Australia, Europe, and North America.

Step counts (in steps/day) were determined using step-counting devices worn by the participants for 1 week. Step frequency (when available) was used as an indirect measure of exercise intensity.

The primary outcome was all-cause mortality, which was assessed over an average follow-up duration of 7.1 years.

The results

Compared to the lowest step count per day (3,553), higher step counts were associated with a reduced risk of all-cause mortality. Specifically, the risk of all-cause mortality was 40% lower at 5,801 steps/day, 45% lower at 7,842 steps/day, and 53% lower at 10,901 steps/day. The lowest risk was observed at 7,000–9,000 steps/day.

In adults younger than 60, the lowest risk for all-cause mortality was observed at 8,000–10,000 steps/day — with no additional benefit above this level of activity. For adults 60 and older, the lowest risk of all-cause mortality was observed at 6,000–8,000 steps/day.

The association between step count and all-cause mortality was the same for male and female participants. There was no association between step rate and all-cause mortality.

Note

Due to a shortage of relevant studies, this meta-analysis included both published and unpublished data. However, this may have helped avoid the risk of the results being influenced by a publication bias — a potential strength of this study.

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This Study Summary was published on August 23, 2022.

References

  1. ^Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, Carty C, Chaput JP, Chastin S, Chou R, Dempsey PC, DiPietro L, Ekelund U, Firth J, Friedenreich CM, Garcia L, Gichu M, Jago R, Katzmarzyk PT, Lambert E, Leitzmann M, Milton K, Ortega FB, Ranasinghe C, Stamatakis E, Tiedemann A, Troiano RP, van der Ploeg HP, Wari V, Willumsen JFWorld Health Organization 2020 guidelines on physical activity and sedentary behaviour.Br J Sports Med.(2020-Dec)